Association of Anabolic Steroid Use With Hypertension and Cardiomyopathy: A Case Study

Anabolic-androgenic steroid (AAS) use has always been associated with professional athletes and bodybuilders. Many scandals have shed light on the power of anabolic steroids in enhancing human physique and performance, making them ripe for abuse amongst recreational users. However, there are many dangers of anabolic steroid use that have yet to be uncovered or are slowly making their way into becoming general knowledge, especially as it relates to cardiovascular disease (CVD). These risks may remain masked for years before they are discovered, by which time it may be too late to reverse all the detrimental effects. In this article, we report a case of an otherwise healthy 46-year-old Caucasian male with an admitted history of recent anabolic steroid use who arrived in the emergency department with complaints of left lower extremity swelling and pain, spontaneous bruising of the calf, and shortness of breath for two days. After a thorough evaluation, he was discovered to have underlying essential hypertension (HTN) and heart failure with a reduced ejection fraction of 30%. The patient was educated on the likely effects of steroid use on his condition and the ramifications of having uncontrolled HTN and heart failure. He was advised to discontinue steroid use and begin medical management of these conditions. Ultimately, there isn't an established symptom profile for patients using anabolic steroids, and this unique case of a patient with vague symptomatology who was discovered to have underlying congestive heart failure (CHF) and uncontrolled HTN outlines the need for a thorough investigation of cardiac and vascular body systems in this subset of patients.