Author: Joseph White, MD, MS
Co Author #1: Juan G. Jimenez-Garcia
Co Author #2: Guillermo Izquierdo-Pretel
Co Author #3: Juan R. Santos Rivera
Senior Editor: Justin Mark Young, MD, FAMSSM
Editor: Chelsea Cole, MD
Patient Presentation:
A 37-year-old male bodybuilder and recreational weightlifter is experiencing acutely worsening shortness of breath, diaphoresis, and abdominal pain.
History:
The patient is a 37-year-old male bodybuilder and weightlifter who presented to the ED with acutely worsening shortness of breath, diaphoresis, and abdominal pain. His medical history includes obstructive sleep apnea (managed with CPAP), anabolic steroid use, benzodiazepine use, stimulant use disorder, hypertension, and bilateral quadriceps rupture. Initial imaging revealed a right pleural effusion and a left bronchogenic mass. Due to acute respiratory distress and abnormal imaging findings, he was admitted to the ICU and placed briefly on BiPAP without intubation.
The patient denies any home medications; however, his hormone and supplement regimen are as follows:
Testosterone 1000mg/week
Ecosport 1000mg/week (multivitamin)
Masteron 1000mg/week (Drostanolone propionate/androgen)
Human Growth hormone 10 IU daily
Proviron 50mg daily (Mesterolone/androgen)
Winstrol 50mg daily (Stanozolol/androgen)
Anadrol 1mg daily (Oxymetholone/androgen)
Physical Exam:
Vitals: HR 99, BP 111/98, RR 37, SpO2 97%, Temp 36.9 deg. C
General: Pale appearing, in mild respiratory distress, fatigued appearance.
HEENT: Normocephalic, atraumatic, and anicteric.
Lungs: Coarse with noisy respirations bilaterally. No crackles or accessory muscle use
Heart: Regular rate and rhythm, no murmurs, or gallops.
Extremities: Full range of motion, mild generalized muscle tenderness. Motor strength 5/5 in upper and lower extremities.
Neurological: Alert and oriented with no focal deficits.
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