Introduction: Anabolics are responsible for heavy disturbances in male and female organisms. Probability of heart attack is multiplying, anabolics are causing raise of blood cholesterol, development of atherosclerosis, liver damage, prostate hypertrophy, boldness, aggressive behavior, gynecomastia in men and ovulation disturbances in women. (1-3)

Case report: Forty-eight-year-old male, admitted to Emergency Department for acute anteroseptal ST segment elevation myocardial infarction. He is intensively training in bodybuilding and taking four types of steroids intramuscularly (Testosteron 1 gr. 2 x weekly, Metan 2 x weekly, Trembolan 2 x weekly, Nordipin). On a day he was admitted to hospital, he went cycling for 30 km, he made bodybuilding training in gym for 45 minutes and played two matches of football. Late that night our patient started feeling chest pain, nausea, heavy breathing. He was admitted to hospital sixty minutes after the pain started. 12-lead ECG on arrival: SR 66/min, ST segment elevation for 3 mm in V2 to V5. Laboratory results: cTnT 994 ng/l, AST 247 U/l, ALT 219 u/l, CPK 3366 U/l, LD 346/l. Coronarography was made transradially and subocclusive thrombotic stenosis of proximal LAD with distal embolization was found. Percutaneous coronary intervention was made on LAD and was implanted with optimal result. After the Integrillin bolus LAD was reanalyzed with optimal result. Other coronary arteries were without stenosis. Post interventional period was without complication. Total resolution of ST segment was found on ECG. On echocardiography we found mildly reduced systolic function (LVEF 50%). After discharge from hospital patient went back to his old habits of taking steroids. Two months after hospital discharge he had another episode of chest pain but there were no signs of acute coronary syndrome. Seven days later his exercise stress test was unremarkable.

Conclusion: Anabolic steroids use is widely spread among bodybuilders-amateurs. Anabolic-androgenic steroids are not available on free market but one can get a whole arsenal of these drugs illegally. Person determined to take steroids will do it one way or another, but we have to let these people know what the possible consequences are. Clinical studies on this matter should be made. It is our opinion that education in primary and secondary schools about steroids usage in our environment is necessity.