[Myocardial infarction and anabolic steroid use. A case report]. / Infarctus du myocarde et prise d'anabolisants. A propos d'un cas.

The potential cardiotoxicity of anabolic steroids is not well known. The authors report the case of a young man who was a top class body builder and who developed severe ischaemic cardiomyopathy presenting with an inferior wall myocardial infarction. The clinical history revealed prolonged and intensive usage of two types of anabolic steroids to be the only risk factor. This cardiotoxicity may be related to several physiopathological mechanisms: accelerated atherogenesis by lipid changes, increased platelet aggregation, coronary spasm or a direct toxic effect on the myocytes. The apparent scarcity of the reported clinical details in the literature is probably an underestimation of the consequences of this usage.

[Late discovery of inferior vena cava draining into the left atrium after surgical closure of atrial septal defect]. / Découverte tardive d'une dérivation de la veine cave inférieure dans l'oreillette gauche après fermeture chirurgicale d'une communication interauriculaire.

Drainage of the inferior vena cava into the left atrium during surgery for closure of an atrial septal defect is a rare complication. More common in low situated defects, it was more frequent when this type of surgery was performed without cardiopulmonary bypass. This diagnosis was made in a 45 year old woman with cyanosis operated 28 years previously. The right-to-left shunt was demonstrated by the hyperoxia test and confirmed by perfusion pulmonary scintigraphy and contrast echocardiography but only when the contrast was injected in the inferior vena cava territory, and by angiography. The surgeon confirmed the abnormality, closed the interatrial septum and reconnected the inferior vena cava to the right atrium.