A 59-year-old patient with a history of avid weight lighting and prolonged AAS use presented with progressive fatigue and dyspnea on exertion. Imaging revealed the presence of significant left ventircular hypertrophy with both diastolic and systolic dysfunction. Findings were attributed to the patient's long term AAS use. The patient was counseled to cease AAS use and optimize medical therapy for CAD and HTN.
Anabolic androgenic steroids (AAS), including testosterone and synthetic derivatives, have been used by elite bodybuilders for decades to increase muscle mass and strength; however, many AAS users at present are not competitive athletes but young to middle-aged men who use the drugs to enhance personal aesthetics. Long-term supraphysiologic doses of AAS have been associated with various adverse cardiovascular effects including left ventricular hypertrophy and diastolic dysfunction. Additional associations between AAS use and sudden cardiac death, arryhthmias, myocardial infarction, accelerated atherosclerosis, and hypercoagulable states have been reported. While systolic dysfunction induced by AAS may be reversible, diastolic dysfunction secondary to AAS use may not be fully reversible.

Left Ventricular Dysfunction in the Setting of Long-Term Anabolic Androgenic Steroid Use