{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T04:07:49Z","timestamp":1745640469385,"version":"3.40.4"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"published-print":{"date-parts":[[2009]]},"abstract":"<jats:p>The aetiology of left ventricular hypertrophy (LVH) in an athlete is often difficult to identify. We describe a 29-year-old fitness instructor who was referred for investigation of syncope. He gave a history of intensive weight lifting and anabolic steroid use at supra-therapeutic doses for the preceding 6 years. Electrocardiography showed inferolateral repolarisation abnormalities and a transthoracic echocardiogram demonstrated asymmetrical LVH with reduced left ventricular cavity dimensions. There was no left ventricular outflow tract obstruction or systolic motion of the anterior mitral valve leaflet. These findings were confirmed on cardiac magnetic resonance imaging (CMR). The differential diagnosis included athlete\u2019s heart, steroid-induced cardiomyopathy and non-obstructive hypertrophic cardiomyopathy. The patient was advised to discontinue both steroid use and intensive training. After 3 years of steroid abstinence but continued training, the syncopal episodes and the ECG abnormalities completely resolved, associated with regression of LVH on echocardiography and CMR.<\/jats:p>","DOI":"10.1136\/bcr.10.2008.1080","type":"journal-article","created":{"date-parts":[[2009,12,2]],"date-time":"2009-12-02T06:59:57Z","timestamp":1259737197000},"page":"bcr1020081080","source":"Crossref","is-referenced-by-count":0,"title":["Identifying the aetiology of left ventricular hypertrophy in an athlete: importance of lifestyle modification"],"prefix":"10.1136","volume":"2009","author":[{"given":"Miriam Jane","family":"Ball","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niall","family":"Keenan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Lynch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Prasad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana A","family":"Gorog","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2009,12,1]]},"reference":[{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02602-5"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2008.02.006"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.08.064"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.4","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/j.1600-0838.1993.tb00358.x","article-title":"Noninvasive cardiac evaluation of weight-lifters using anabolic steroids","volume":"3","author":"Deligiannis","year":"1993","journal-title":"Scand J Med Sci Sports"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.5","doi-asserted-by":"crossref","first-page":"465","DOI":"10.2459\/JCM.0b013e3280104269","article-title":"Marked left ventricular hypertrophy mimicking hypertrophic cardiomyopathy associated with steroid therapy for congenital adrenal hyperplasia","volume":"8","author":"Scire","year":"2007","journal-title":"J Cardiovasc Med (Hagerstown)"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.6","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(93)90089-R"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.7","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2006.030171"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.8","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1055\/s-2007-1024703","article-title":"Anabolic steroid use in body builders: an echocardiographic study of left ventricle morphology and function","volume":"12","author":"De Piccoli","year":"1991","journal-title":"Int J Sports Med"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.9","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1093\/oxfordjournals.eurheartj.a014724","article-title":"Serious cardiovascular side effects of large doses of anabolic steroids in weight lifters","volume":"17","author":"Nieminen","year":"1996","journal-title":"Eur Heart J"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.10","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.015719"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540030033028"},{"key":"2025042508205377000_2009.dec01_1.bcr1020081080.12","doi-asserted-by":"crossref","first-page":"346","DOI":"10.5694\/j.1326-5377.1993.tb121797.x","article-title":"Anabolic steroid abuse and cardiac death","volume":"158","author":"Kennedy","year":"1993","journal-title":"Med J Aust"},{"issue":"Suppl 5","key":"2025042508205377000_2009.dec01_1.bcr1020081080.13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2165\/00003495-198800355-00002","article-title":"Left ventricular hypertrophy. 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