Anabolic Steroid-induced Reversible Cardiomyopathy in a Young Non-athletic Female

Abstract

Anabolic androgenic steroid (AAS) abuse is widespread nowadays, not only in athletes but in non-athletic populations; and rapidly becoming a public health challenge. Cardiomyopathy (both dilated and hypertrophic) is a known complication of anabolic steroid use. A 47-year woman presented with acute pulmonary edema, in the background of exertional dyspnea for the last few weeks. Echocardiogram revealed severe left ventricular systolic dysfunction in the presence of hypertrophy, global hypokinesia, and septal dyssynchrony. She was treated with guideline-directed treatment for heart failure. Investigation into the causes revealed that she had been using anabolic of steroids for social reasons. She was counselled and managed to abstain from the use steroids. Cardiac MRI, five months later, showed mild left ventricular systolic impairment and no hypertrophy. There was no perfusion defect, scar or infiltration. At nine months follow-up, she improved symptomatically with better exercise tolerance.