Adams-Stokes Syndrome Associated With Chronic Heart Block

The authors report on six patients in whom prednisone therapy either permanently or temporarily diminished or eliminated heart block and abolished the associated attacks of syncope. The attacks were eliminated within 24 hours after the beginning of corticosteroid therapy, whether or not the heart block was alleviated. The case histories illustrate the relief afforded by prednisone, the recurrence of heart block when dosages were reduced or interrupted, the occasional absence of symptoms in the presence of recurrent heart block, and the occasional failure of the patient to respond further to dosages of prednisone that had previously been effective. The drug was given in doses of 60 mg. per day initially, and it was not always possible to reduce the dosage to 30 mg. without a return of the syndrome. Prednisone sometimes was effective after atropine and isoproterenol had failed, and no untoward results followed the simultaneous administration of all three drugs.