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I’ve had these discussions over and over with my team of cardiologist- sports cardiologist and interventional cardiologist who has background in sports cardiology prior and is a former power lifter so takes a personal interest.I laugh because I know many who have abused GH and steroids heavily for decades and it's really hard for me to find anyone among them who would be in worse health today than the average Joe at his age.
besides - we have to pay the price for being superhuman, nothing is free
Dr. Kim at Emory works with the elite pro teams and athletes so managing cases with PEDs is a staple of his job and the norm.
They both strongly feel that athletes, especially athletes who lift heavy such as bodybuilders will naturally have some level of athletes heart. It’s almost alarming to them to see one who doesn’t as they worry of low EF rates in those cases.
The heart is a muscle and in a performing athlete with muscle it is almost second nature or abnormal to not have athletes heart at that level. They believe there’s no risk or danger in having it as long as BP and HR are in range as you said. They believe breathing and BP during lifts play a huge factor in the extent of this as well as most are aware or thinking to manage their BP during exercise which strains the heart at more extreme level.
Of course there are other factors to consider such as monitoring homocysteine and HSCRP. Screening for calcium build up, monitoring EF% annually and if breathing is an issue doing a CPET test to see how the heart and lungs are functioning together under exercise.
The one thing we all agree on is that as a bodybuilder or any top athlete using PED’s should get annual heart screening- for me that’s an echo and CPET. This is in addition to 4-8 week monitoring of HSCRP and homocysteine on bloodwork and lipids of course.
I say all of this in reference to someone healthy with no previous damage or heart conditions. I know you have a history so to me that would change all factors and know my cardiologist would agree as once an athlete has damage they don’t suggest PED’s as any part of managing the case. Dr. Kim has told me of cases he has, but at that point he said it becomes a warning of advising them not to do it then treating with beta blockers and medications under strict monitoring and doing MRI’s to asses and monitor deeper.