“…O u r contention is that the heart block was most probably due to radiation myocarditis or injury to the small vessels supplying the distal parts of the conduction system, known to be maximally affected in all forms of myocardiopathy. 28 Whether the progression of bifascicular block to complete heart block in the first patient was related to the initiation of corticosteroid therapy, or occured spontaneously, as suggested by the two previous fainting episodes, is open to conjecture. Enhancement of conduction through the atrioventricular node by corticosteroids has been reported by several investigators; 1,13,20.39,40,43 h owever, deleterious effects of long-term corticosteroid therapy o n the cardiovascular system have been also frequently described, 2,3,4,8,14,24,26, 49 It is possible that some of the undesirable effects of corticosteroids, such as hypercoagulability, l 2 sodium potassium imbalance,6,'6 or others, have deleterious effects on distal Conduction through the bundle branches.…”