CTICasesMyopericarditis Associated with Anabolic Steroid Use
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Imaging findings
Cardiac MRI demonstrates patchy, late gadolinium enhancement (LGE) with a non-ischemic pattern, including mid-myocardial enhancement in the septum and epicardial/pericardial enhancement along the lateral left ventricular wall. The coronary arteries are angiographically normal, and the left ventricle is dilated.
Key takeaways
Anabolic steroid abuse is a known but underrecognized cause of dilated cardiomyopathy and acute toxic myopericarditis in young, high-performance athletes. On cardiac MRI, this condition typically manifests as non-ischemic delayed enhancement (mesocardial or epicardial), mimicking viral myocarditis or sarcoidosis, and should be considered in the differential diagnosis of unexplained cardiomyopathy or arrhythmias in this patient population.
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