Massive Pulmonary Embolus and Anabolic Steroid Abuse

To the Editor. —Several case reports associating anabolic steroid abuse with arterial thrombosis in young male weight lifters have appeared in the literature.1-3Herein we present a case of fatal pulmonary embolus in a 36-year-old power lifter. Report of a Case. —The patient had a clinical history of long-standing anabolic steroid abuse and type II diabetes mellitus. Three months before his death, the patient was diagnosed as having right lower lobe pneumonia and was treated as an outpatient. The patient was next seen at the emergency department after collapsing in the street. He was noted to be combative but conscious and complaining of shortness of breath. Within minutes of arrival, the patient suffered cardiopulmonary arrest. Repeated arterial blood gas measurements showed marked hypoxemia and hypercarbia. A clinical diagnosis of fatal pulmonary embolus was made. The postmortem examination disclosed a large saddle pulmonary embolus obstructing both the right and left