Anabolic Androgenic Steroid Use as a Cause of Fulminant Heart Failure

A 39-year-old male weightlifter presented in fulminant heart failure. An echocardiogram revealed severe global biventricular failure. Left ventricular (LV) systolic function was estimated at 15%. His dilated cardiomyopathy was attributed to his use of both testosterone and boldenone in the 3-month period before his presentation. Although the deleterious effects of androgenic- anabolic steroids on diastolic function are well known, the effects of these drugs on systolic function is an area of ongoing investigation. Our case suggests that androgenic anabolic steroid use should be considered in the differential diagnosis of patients presenting with acute heart failure.