Steroid-Induced Cardiomyopathy: Insights From a Systematic Literature Review and a Case Report

Anabolic-androgenic steroids (AAS) abuse is associated with severe cardiovascular risks, particularly AAS-induced cardiomyopathy. This systematic review highlights that most cases show left ventricular dilation and reduced ejection fraction. AAS, synthetic testosterone derivatives, are widely used to enhance athletic performance and muscle mass. However, misuse of AAS is associated with severe cardiovascular complications, including AAS-induced cardiomyopathy. This study presents a case of AAS-induced cardiomyopathy and systematically reviews the existing literature on the condition. A systematic search was conducted across PubMed, Web of Science, Cochrane, and Google Scholar using relevant terms related to AAS and cardiomyopathy. Studies were reviewed to assess clinical presentations, patient demographics, AAS regimens, diagnostic methods, and treatment strategies. The JBI critical appraisal tool was used to evaluate risk of bias. The review included 32 cases of AAS-induced cardiomyopathy, predominantly in males (97%), with a mean age of 38.3 years. Most patients exhibited left ventricular dilation, reduced ejection fraction, and mitral regurgitation. Most cases showed improvement in heart function after discontinuation of AAS and heart failure treatment. AAS misuse poses significant cardiovascular risks, particularly cardiomyopathy. AAS effect on cardiac remodeling may lead to sudden cardiac death. While some patients recover after cessation, others may require lifelong management. Greater awareness and research are needed to betterunderstand and manage AAS-induced cardiomyopathy.