Strong muscles, weak heart: testosterone-induced cardiomyopathy

Strong muscles, weak heart: testosterone-induced cardiomyopathy / Sarah Doleeb, Ann Kratz, Monica Salter, Vinay Thohan. - (ESC Heart Failure (2019) 9 July; p. 1-5).
- PMID: 31287235.
- DOI: 10.1002/ehf2.12494


Exogenous anabolic androgen steroid use is associated with adverse cardiovascular outcomes. A 53-year-old bodybuilder presented with 3 months of exertional dyspnoea. Physical examination showed tachycardia and pan-systolic murmur; an echocardiogram showed a left ventricular ejection fraction (EF) of 15%. Evaluations included normal coronary angiogram, iron panel and thyroid studies, a negative viral panel (human immunodeficiency virus, Lyme disease, and hepatitis), and urine toxicology. He admitted to intramuscular anabolic steroid use; his testosterone level was 30 160.0 ng/dL (normal 280-1100 ng/dL). In addition to discontinuation of anabolic steroid use, he was treated with guideline-directed heart failure medical therapy. Repeat echocardiogram at 6 months showed an EF of 54% and normalized testosterone level of 603.7 ng/dL. Anabolic steroid use is a rare, reversible cause of cardiomyopathy in young, otherwise healthy athletes; a high index of suspicion is required to prevent potentially fatal side effects.

Original document


Case report
9 July 2019
Doleeb, Sarah
Kratz, Ann
Salter, Monica
Thohan, Vinay
United States of America
Other organisations
Aurora Health Care
Doping classes
S1. Anabolic Agents
Medical terms
Cardiovascular diseases
Health effects
Gym/fitness environment
Date generated
2 July 2019
Date of last modification
24 July 2019
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