Corticosteroids may cause sodium retention; which condition requires close monitoring?

• A. Diabetes mellitus
• B. Seizure disorders
• C. Heart failure
• D. Hyperthyroidism

Answer: (C)

Corticosteroids can cause sodium and water retention, which increases the circulating volume. In heart failure, where the heart’s pumping ability is limited, this extra fluid raises preload and can worsen edema and pulmonary congestion, potentially triggering decompensation. Therefore, close monitoring is essential to detect fluid overload early—watch for weight gain, leg or abdominal edema, crackles in the lungs, shortness of breath, and signs of increased blood pressure or electrolyte imbalance. While steroids can affect other conditions (for example, raising blood glucose in diabetes), the fluid-overload concern driven by sodium retention is most critical in heart failure.