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We report a case of an acute ST-segment elevation myocardial infarction in a patient with traditional cardiac risk elements utilizing supraphysiologic doses of supplemental, intramuscular testosterone. In addition, this patient also had polycythemia, probably secondary to high-dose testosterone. The patient underwent profitable percutaneous intervention of the best coronary artery. Physicians and patients ought to concentrate on the medical penalties 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 component of endothelial dysfunction has been proposed, which may contribute to abnormal vessel reactivity.
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Patients also could additionally be taking concomitant stimulants, corresponding to ephedra, which might confound information and the potential for adverse events. It is most likely going that the frequency of cardiac events is underreported within the medical literature. Moreover, testosterone has been used in the treatment of decreased muscle mass and bone density in addition to anemia. The role testosterone may play within the growth of cardiovascular disease has increasingly become the subject of present curiosity . Supraphysiologic doses of anabolic-androgenic steroids , which embody greater than 30 natural and artificial derivatives of testosterone, might trigger a large spectrum of medical sequalae. Supplemental or physiologic doses of testosterone have seen expanded use in medical follow recently. Other common potential opposed effects embody infertility, hepatotoxicity, psychological abnormalities, and gynecomastia .
However, testosterone in physiologic doses may even be beneficial in patients with angina , have greater ischemic thresholds and improved quality of life . Short-term intracoronary administration of testosterone induces coronary artery dilation and will increase coronary blood flow in males with established coronary artery illness . Therefore, an interaction of endogenous elements of the patient’s risk profile in addition to the testosterone dosing may be issues of whether or not adverse events occur. Erythrocytosis has been reported as a potential effect of testosterone, which can be beneficial in sufferers with anemia.
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