Anabolic androgenic steroids-induced acute “Tombstone” ST-segment elevation myocardial infarction

Anabolic-androgenic steroids (AAS) are frequently used to treat a wide variety of pathological medical conditions including but not limited to hypogonadism, aplastic anemia, and metastatic breast cancer. Nonetheless, the abuse of AAS continues to rise among professional and recreational athletes despite their deleterious adverse effects. Here, we report a 34-year-old male, with a history of nonmedical use of AAS for 2 months, who had persistent severe retrosternal chest pain. His electrocardiogram was suggestive of acute anteroseptal ST-segment elevation myocardial infarction. He underwent urgent coronary angiography which revealed a thrombotic burden in the left anterior descending artery without underlying atherosclerosis.