{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:19:55Z","timestamp":1789154395473,"version":"build-2803163510"},"reference-count":11,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,2,19]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>A professional bodybuilder in his 20s presented to the cardiology emergency with acute, retrosternal chest pain and diaphoresis lasting 3\u2009hours. He reported using clenbuterol, a sympathomimetic drug known for its anabolic and lipolytic effects, at escalating doses up to 180 \u00b5g daily. ECG revealed normal sinus rhythm with ST-segment elevation in the anterior leads with raised serum troponin levels. Coronary angiography identified a grade IV thrombus in the proximal left anterior descending artery with thrombolysis in myocardial infarction 3 flow and normal flow in the remaining vessels. The patient was treated medically with anticoagulation, antiplatelets and statins and discharged on dual antiplatelet therapy, statins and guideline-directed medical therapy. This case highlights the importance of considering clenbuterol-induced vasospasm and thrombosis as a precipitating factor for acute coronary syndrome in young patients without traditional risk factors.<\/jats:p>","DOI":"10.1136\/bcr-2025-264898","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T16:40:35Z","timestamp":1741020035000},"page":"e264898","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Clenbuterol-induced myocardial infarction in a young bodybuilder"],"prefix":"10.1136","volume":"18","author":[{"given":"Abhinav","family":"Aggarwal","sequence":"first","affiliation":[{"name":"Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar Hussian","family":"Ansari","sequence":"additional","affiliation":[{"name":"Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermohender Singh","family":"Isser","sequence":"additional","affiliation":[{"name":"Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1136-6353","authenticated-orcid":false,"given":"Devesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"key":"2025082700061964000_18.3.e264898.1","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.tvjl.2008.08.021","article-title":"Clenbuterol and the horse revisited","volume":"182","author":"Kearns","year":"2009","journal-title":"Vet J"},{"key":"2025082700061964000_18.3.e264898.2","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1007\/s00414-023-02996-1","article-title":"Adverse events of clenbuterol among athletes: a systematic review of case reports and case series","volume":"137","author":"Kumari","year":"2023","journal-title":"Int J Legal Med"},{"key":"2025082700061964000_18.3.e264898.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(19)33465-5"},{"key":"2025082700061964000_18.3.e264898.4","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2021-247898","article-title":"Clenbuterol-induced myocarditis in a young man desiring to lose weight","volume":"15","author":"Lopes","year":"2022","journal-title":"BMJ Case Rep"},{"key":"2025082700061964000_18.3.e264898.5","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.ajem.2006.12.022","article-title":"Pulmonary edema and respiratory failure associated with clenbuterol exposure","volume":"25","author":"Schechter","year":"2007","journal-title":"Am J Emerg Med"},{"key":"2025082700061964000_18.3.e264898.6","article-title":"Clenbuterol-Induced Myocarditis: A Case Report","volume":"7","author":"Moriarty","year":"2020","journal-title":"Eur J Case Rep Intern Med"},{"key":"2025082700061964000_18.3.e264898.7","first-page":"131","article-title":"Case report and review of clenbuterol cardiac toxicity","volume":"8","author":"Barry","year":"2013","journal-title":"J Cardiol Cases"},{"key":"2025082700061964000_18.3.e264898.8","doi-asserted-by":"publisher","DOI":"10.1253\/circj.69.1144"},{"key":"2025082700061964000_18.3.e264898.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2012.02.057"},{"key":"2025082700061964000_18.3.e264898.10","first-page":"89","article-title":"Clenbuterol toxicity: an emerging epidemic. 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