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We report a case of an acute ST-segment elevation myocardial infarction in a patient with traditional cardiac risk components utilizing supraphysiologic doses of supplemental, intramuscular testosterone. In addition, this patient additionally had polycythemia, probably secondary to high-dose testosterone. The patient underwent successful percutaneous intervention of the right coronary artery. Physicians and patients ought to pay consideration to the medical consequences of anabolic steroid abuse. Development of an atheromatous plaque perpetuates endothelial dysfunction and promotes platelet aggregation and intracoronary thrombus formation (Ajayi et al 1995; Nieminen et al 1996). Moreover, a element of endothelial dysfunction has been proposed, which may contribute to abnormal vessel reactivity.

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However, testosterone in physiologic doses could even be beneficial in patients with angina , have higher ischemic thresholds and improved high quality of life . Short-term intracoronary administration of testosterone induces coronary artery dilation and will increase coronary blood circulate in males with established coronary artery disease . Therefore, an interaction of endogenous elements of the patient’s danger profile as well as the testosterone dosing may be issues of whether or not antagonistic events occur. Erythrocytosis has been reported as a potential impact of testosterone, which may be helpful in sufferers with anemia. The greatest risk of erythrocytosis happens with injectable forms of testosterone compared with transdermal preparations, especially in supraphysiologic doses. An increase of up to 44% of the baseline hematocrit has been reported .

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Moreover, testosterone has been used in the treatment of lowered muscle mass and bone density as nicely as anemia. The role testosterone may play within the development of cardiovascular disease has more and more turn into the subject of present interest . Anabolic androgenic steroid use has increased over the past decade, regardless of its potential for adverse results. They continue to be used by Olympic stage athletes, and have even spread to high school stage athletes, noncompetitive bodybuilders and recreational athletes (Sullivan et al 1998; Dhar et al 2007).

Anabolic Steroids, Acute Myocardial Infarction And Polycythemia: A Case Report And Review Of The Literature

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Unfortunately, the information on using high dose anabolic steroids in people are mainly provided as case stories or small research that lack adequate management teams. In addition, the data available within the literature doesn’t account for the steroid type or dose, as neither could additionally be recognized. Patients additionally could also be taking concomitant stimulants, corresponding to ephedra, which may confound information and the potential for antagonistic occasions. It is probably going that the frequency of cardiac events is underreported within the medical literature. Supraphysiologic doses of anabolic-androgenic steroids , which embody greater than 30 pure and artificial derivatives of testosterone, might trigger a large spectrum of medical sequalae.

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