The decision to use glucocorticoids in this case was based on the diagnosis of rheumatic myocarditis. Glucocorticoids are commonly used in the treatment of autoimmune and inflammatory conditions, including myocarditis. They have potent anti-inflammatory and immunosuppressive effects, which can help reduce inflammation in the heart muscle and improve symptoms.
Glucocorticoids can lead to hypertension (high blood pressure) and gastric ulcer bleeding as side effects. One mechanism is through their mineralocorticoid-like activity, which can cause sodium and water retention, leading to increased blood volume and elevated blood pressure. Additionally, glucocorticoids can impair the production of protective factors in the stomach lining, such as prostaglandins, that help maintain the integrity of the gastric mucosa. This can make the stomach more susceptible to damage from acid secretion, leading to gastric ulcers.
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