[Dilated cardiomyopathy in a user of anabolic steroids]

A case is described in which a 32-year old male body-builder was admitted with signs of cardiac incompensation after using anabolic steroids (AS) in large amounts for three weeks before admittance. Echo-cardiography showed a dilated left ventricle with decreased systolic function and electrocardiography showed atrial fibrillation. Response to treatment was good and he was discharged to further out-patient treatment. After nine weeks he was admitted with severe cardiac incompensation. There was no response to treatment and he died after three days. At autopsy the heart weighted 527 grams and was diffusely dilated. There were no signs of infarction. Microscopy showed scattered lymphocyte infiltrates consistent with dilated cardiomyopathy, possibly caused by myocarditis. There were no signs of bacterial infection, the patient was a non-alcoholic and no other known cause of myocarditis was shown. We conclude that the patient died from toxic myocarditis with dilated cardiomyopathy caused by AS.