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Anabolic steroids almost kill bodybuilder pro during operation

A fifty-year-old American ex-professional bodybuilder nearly died on the operating table. Doctors at Harvard Medical School describe in the Journal of Cardiothoracic and Vascular Anesthesia how, during an operation to remove a malignant tumour, they discovered that the man had a serious heart defect. It almost cost him his life.

The bodybuilder appeared to be a picture of health. He'd never had a serious illness, except for the tumour in his upper body near his spinal column, which had started to grow rapidly. The doctors decided to remove the tumour. The bodybuilder, with a BMI of 35.9 but still well muscled, lay down on the operating table and was given anaesthetic. That's when things started to go wrong. The guy's blood pressure dropped suddenly.

Anabolic steroids almost kill bodybuilder pro during operation
The bodybuilder's heart was not up to the surgery, the doctors discovered. His heart valves had hardened, but that wasn't the problem. What was more serious was that the walls of the left ventricle had thickened. [The thickened walls are the dark shaded part in the drawing on the right.]

The left ventricle is the part of the heart muscle that pumps oxygen-rich blood into the body. Because the heart has to pump against a lot of resistance during strength training, blood pressure rises dramatically during heavy sets. That's why many strength athletes have an enlarged wall to their left ventricle. This in itself is not dangerous but if strength athletes use high doses of muscle strengtheners on a regular basis, the thickening can become so extreme that the left ventricle no longer functions properly.

Anabolic steroids almost kill bodybuilder pro during operation
But the bodybuilder's heart had another defect as well. The wall between the left and the right ventricle the septum had thickened to 2.2cm. [See figure at left.] This was messing up the heart function even more.

The bodybuilder's tumour was malignant, so the doctors decided they had to continue the operation. They gave the unconscious bodybuilder medicines to keep his heart going and removed the swelling, keeping their fingers crossed.

After the bodybuilder had come round from the operation the doctors asked whether he had used steroids. His answer was yes, he had done so, but twelve years ago, when he was still doing competitive bodybuilding.

"If you encounter a competitive bodybuilder, you must ask whether they use anabolic steroids ", the doctors advise their colleagues. "And you must screen for heart defects. Before cutting him open."

Cardiothorac Vasc Anesth. 2009 Apr;23(2):208-10.

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