SHM Converge Scientific Abstract ePoster Gallery-A Rare Case of Acute Myocardial Infarction and Renal Infarction Due to Testosterone Induced Polycythemia

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This case describes a 46-year-old man with chronic polycythemia, recurrent deep vein thromboses, and long-term testosterone use who presented with acute chest pain and was diagnosed with an inferior and lateral ST-elevation myocardial infarction (STEMI). Laboratory testing showed marked erythrocytosis, with hemoglobin 19.5 g/dL and hematocrit 58%. Cardiac catheterization revealed a 100% mid-circumflex artery occlusion, treated with angioplasty and a drug-eluting stent. Echocardiography also found a large left ventricular thrombus. He was treated with antiplatelet therapy and anticoagulation.<br /><br />Further workup for hypercoagulability, including JAK2 mutation testing, was negative, and hematology attributed his polycythemia to testosterone therapy, recommending phlebotomy. Shortly after discharge, he returned with abdominal pain, and CT angiography showed multiple left renal cortical infarcts. He was again treated with anticoagulation and discharged with close follow-up.<br /><br />The report emphasizes that testosterone therapy, especially at supraphysiologic doses, can cause erythrocytosis and increase the risk of both venous and arterial thrombosis. The case is notable for the combination of STEMI, left ventricular thrombus, and renal infarction, illustrating the severe thrombotic consequences of testosterone-induced polycythemia. The authors stress the need to screen for non-prescribed anabolic steroid use, monitor hematocrit closely, and reserve testosterone therapy for patients with clear hypogonadism and appropriate follow-up.

Asset Subtitle

Safeera Javed

Meta Tag

Author List Noorulaain Bhatti, Safeera Javed

Category Clinical Vignettes

Concept Testosterone-Induced Polycythemia

Concept Thrombus

Concept Arterial Thrombosis

Concept Venous Thrombosis

Concept Myocardial Infarction

Distinguished Non-Finalist

Presenter Organization Baylor College of Medicine

Presenting Author Safeera Javed

Track Adult

Keywords

testosterone therapy

polycythemia

STEMI

left ventricular thrombus

renal infarction

thrombosis

erythrocytosis

deep vein thrombosis

drug-eluting stent

anabolic steroid use

Testosterone-Induced Polycythemia

Thrombus

Arterial Thrombosis

Venous Thrombosis

Myocardial Infarction