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May 2025 Br J Cardiol 2025;32(2) doi:10.5837/bjc.2025.023 Online First

Devastating impact of performance-enhancing drugs: a case of severe heart failure in a young bodybuilder with body dysmorphic disorder

Ismail Sooltan, Sudantha Bulugahapitiya

Abstract

Introduction Performance-enhancing drug (PED) use is a growing concern in physique-focused sports. While cardiovascular risks are known, severe heart failure in young, healthy individuals is rare. PED use is often driven by competitive desires and body image issues, frequently linked to disorders like body dysmorphic disorder (BDD). This case report details a young bodybuilder with newly diagnosed BDD who developed severe heart failure from long-term PED abuse. It emphasises the potential cardiovascular risks in seemingly healthy individuals and the need for early, multidisciplinary intervention addressing both physical and psychological asp

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