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Sudden cardiac death in anabolic androgenic steroids abuse: case report and literature review

Forensic Sciences Research 2019年第3期4卷 267-273页

作者： Ana Isabel Hernández-Guerra Javier Tapia Luis Manuel Menéndez-Quintanal Joaquín S.Lucena Histopathology Service National Institute of Toxicology and Forensic Sciences(NITFS)Canary Islands DepartmentTenerifeSpain Forensic pathology Service Institute of Legal Medicine and Forensic Sciences(ILMFS)Las Palmas de Gran CanariaSpain Chemistry Service NITFSCanary Islands DepartmentTenerifeSpain Forensic pathology Service ILMFSSevilleSpain

Anabolic androgenic steroids (AAS) have several adverse effects on the cardiovascular system that may lead to a sudden cardiac death (SCD).We herein report a case involving a 24-year-old male,AAS abuser with intramuscular delivery in the 6 months before,who suffered a cardiorespiratory arrest at home's bathtub when returning from New Year's party.A forensic autopsy was performed according to the guidelines of the Association for European Cardiovascular pathology (AECVP).The body showed hypertrophy of skeletal musculature,with low amount of subcutaneous fat and no signs of injury (body mass index,BMh 26.8 kg/m^(2)).On internal examination,there were multiorgan congestion,acute pulmonary edema,and cardiomegaly (420 g) with severe coronary atherosclerosis and superimposed acute occlusive thrombosis at the left main trunk and left anterior *** of scarring were located at the intersection between the posterior wall and the posterior third of the septum (postero-septal).At histology,acute myocardial infarction at the anterior third of the septum and the anterior wall,and subacute myocardial infarction at apical septum and apical posterior wall were *** findings were small intramyocardial vessel disease and myocytes *** analysis in blood showed ethanol ((0.90 ±0.05) g/L),stanazolol (11.31 μg/L),nandrolone (2.05μg/L) and testosterone (<1.00μg/L).When confronted with a sudden death in a young athlete we must pay attention to the physical phenotype that may suggest AAS abuse and perform a detailed examination of the *** analysis is a key to establish the relationship between SCD and AAS abuse.

关键词： Forensic sciences forensic pathology anabolic androgenic steroids(AAS) sudden cardiac death autopsy cardiac pathology toxicology

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