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Anabolic steroid misuse is an important reversible cause of cardiomyopathy: a case report.

Authors :
Milevski SV
Sawyer M
La Gerche A
Paratz E
Source :
European heart journal. Case reports [Eur Heart J Case Rep] 2022 Jul 02; Vol. 6 (7), pp. ytac271. Date of Electronic Publication: 2022 Jul 02 (Print Publication: 2022).
Publication Year :
2022

Abstract

Background: Anabolic steroid misuse is very common and has been linked to the development of a severe cardiomyopathy, arrhythmias, and sudden death.<br />Case Summary: A 46-year-old miner presented to hospital with subacute dyspnoea and palpitations. Investigations revealed atrial fibrillation and a severe dilated cardiomyopathy with left ventricular ejection fraction of 12%. The patient had a history of longstanding exogenous testosterone administration. Haematological investigations demonstrated a marked polycythaemia, with haematocrit of 0.60 L/L (normal 0.40-0.54 L/L). Hormonal investigations revealed an elevated testosterone level of 46.4 nmol/L (normal 8.0-30.0 nmol/L) and suppressed luteinizing and follicle-stimulating hormones, consistent with excess testosterone use. The patient was referred to the endocrinology specialty team for support with ceasing excess testosterone use, while commencing guideline-directed heart failure therapy. At 6 months of follow-up, the patient's left ventricular ejection fraction had normalized and he was asymptomatic. Biochemical indicators of testosterone excess had also normalized.<br />Discussion: Anabolic steroids are widely misused, particularly among young and middle-aged males. Cardiovascular complications include a potentially reversible severe cardiomyopathy, accelerated coronary disease, dyslipidaemia, arrhythmias, and sudden death. It is important to identify a history of anabolic steroid misuse when investigating cardiomyopathy and be alert for indicators such as polycythaemia. Cessation of anabolic steroid misuse may lead to complete reversal of cardiomyopathy but should be undertaken in close partnership with the patient and endocrinologists.<br /> (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Details

Language :
English
ISSN :
2514-2119
Volume :
6
Issue :
7
Database :
MEDLINE
Journal :
European heart journal. Case reports
Publication Type :
Report
Accession number :
35854893
Full Text :
https://doi.org/10.1093/ehjcr/ytac271