Sudden cardiac arrest following ventricular fibrillation attributed to anabolic steroid use in an adolescent

Abstract

Anabolic androgenic steroids are synthetic derivatives of testosterone that promote the growth of skeletal muscles and have many recognised cardiovascular effects. We report the clinical presentation and pathological findings of an adolescent male whose sudden cardiac arrest following ventricular fibrillation was attributed to anabolic androgenic steroid use. The age of our patient reflects the usage of anabolic androgenic steroids among younger athletes and highlights the need for increased awareness among practitioners.

Strong muscles, weak heart: testosterone‐induced cardiomyopathy

“…Animal studies have demonstrated that exogenous AAS administration has deleterious cardiovascular effects including indirect neurohormonal activation and direct androgenic receptor stimulation resulting in hypertension, myocyte hypertrophy and extracellular fibrosis, apoptotic cell death, premature coronary artery disease, and arrhythmogenesis . Multiple reports of exogenous AAS have been linked with adverse cardiovascular outcome in humans, and long‐term testosterone use may lead to hypertension and stroke, cardiac diastolic and systolic dysfunction, coronary artery disease, arrhythmias, and sudden death …”

“…Gender‐based differences in cardiovascular disease incidence, prevalence, and severity may, in part, be related to the difference in endogenous sex hormones. The use of exogenous anabolic androgen steroids (AASs) for bodybuilding is increasing among young athletes in the USA, and some reports link AAS use to adverse cardiovascular outcomes . In this report, we highlight the anabolic steroid as a potential cause of cardiomyopathy that resolved upon discontinuation.…”

Anabolic Steroids and Cardiovascular Outcomes: The Controversy

“…Alizade et al suggested that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were increased in bodybuilders that used AS, and this may lead to ventricular arrhythmias [47]. This was referenced in a case report published by Lichtenfeld et al of an AS user who died of ventricular fibrillation [48]. In 2019, Marocolo et al concluded that AS is associated with cardiac autonomic dysfunction and ventricular repolarization, and reflected an increase in QT interval [49].…”

Consumption of avocado oil (Persea americana) improves the biochemical profile of rats submitted to long-term androgenic stimulation

“…testosterone use, as an anabolic agent, and the occurrence of cardiovascular disease (CVD) (5,6). In many cases, a random use of anabolic steroids might lead to increased blood pressure, myocardial infarction, renal and hepatic damage, and even death in individuals without a previous history of disease (1,(7)(8)(9)(10)(11). Certain other dysfunctions also occur, which degrade the user's quality of life.…”