Since I have had a heart attack and have 8 stents holding open my coronary arteries, I will comment. Many steroids will torch your cholesterol profile and without cholesterol meds left untreated will certainly contribute to lesions that will build and ultimately block blood flow in the coronary arteries leading to a heart attack. This is a slow process that takes years to develop into a chronic condition.

If you are monster big, maintaining say 50-60 lbs. of muscle beyond your genetic max using steroids to do it, it does make the heart work harder and left ventricular hypertrophy can occur as your heart adapts to pumping blood through all that mass. By some miracle I have so far escaped this one. For now, anyways.

There are two tests you can take that will diagnose quite a bit of your heart health. One is an echocardiogram that will measure a boat load of stuff http://www.mayoclinic.org/tests-procedures/echocardiogram/basics/definit... and the other is a little more elaborate - it is a cardiac PET scan (nuclear imaging) that will provide a picture of the condition of your coronary arteries. See http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisof...

Your diet can do wonders to control cholesterol even when using steroids. There is all manner of information on this on the general internet and on this site.

That said, no, steroids do not directly damage the heart muscle, but they can set the stage for coronary artery disease over the long haul for sure.

Finally, in my case, my heart problems are congenital and most likely are not related to my use of steroids or at least that is the opinion of my cardiologist and his colleagues. Also, for the record, while I did have a MI, non of my cardiac muscle was damaged. How that came about is a long story and I can only say the Lord works in mysterious ways. If you want to know my story, PM me and I will gladly share.

often a steroid cycle can cause water retention around the heart wall,edema.common if an ai isnt included in cycle.an x ray can sometimes confuse this as an enlarged heart.symptons include chest pain,and elevated b/p.have experienced this personally.b/p meds and dueretics quickley brought it back to normal.can progress to lungs if not picked up,which causes shortness of breath which worsens when you lie down.

Brother, with all things, there is USE, MISUSE, and ABUSE.

I agree with @switch87x below.

Use "the smallest dose to achieve the desired effect."

I admit, I have an agenda, and I wear it on my sleeve. That agenda is: TO HELP YOUNG MEN AND WOMEN STAY HEALTHY.

I define "health" as a holistic word, including physical well being as well as emotional (mental/spiritual) well being.

Heart health is paramount, and a lot of AAS long term damage seems to be dependent on DURATION OF USE. Some guys use huge amounts of drugs, then properly cycle off for an amount of time that equals their blast + PCT. It gives you body the best chance to recover.

Others will simply use low dose AAS "for a year or two" and they end up FUCKED UP.

DURATION OF USE IS KEY TO THIS ISSUE!!!

Sure, genetics play their role, but so does our choice to put stuff into our bodies. You may get lung cancer cuz of genetics, but smoking increases that chance. You may get a fucked up heart from your genetics, but using AAS increases that chance, and using LONG DURATION AAS is a sure bet that you'll be fucked up in some way, some how, whether it's your heart, your endocrine system, or whatever.

Learn from the vets. Be smart. Use good hygiene. Cycle on, cycle off. There's no magic pill. You gotta choose it, day in and day out. Rant over.

Friends, help me with my agenda that I stated above.

To sum it up briefly brother ... AAS will lead to irreparable heart damage over long term use. This cannot be prevented in any way that we know of in medicine, except for cessation of AAS use.

This damage happens in the form of something called cardiac hypertrophy... Leading to cardiomyopathy and eventually heart failure. The heart is a muscle and grows similarly to your skeletal muscles. The process is complicated, but I encourage you to buy Llewellyns book Anabolics, and study the first few chapters on the physiology of AAS.

In medicine, it's generally accepted the first effective treatment comes in the form of prevention. If you're choosing to use AAS and also believe in living a long, healthy life, to the best of your ability, I encourage you to educate yourself. Keeping your cycles to a maximum of 12 weeks, with proper PCT, time off in between, hydration, diet, bloodwork in the form of hormone panels, CBC, CMP, Lipid levels, monitoring BP... The list goes on.

In my opinion there isnt enough research on these peptides people are running nowadays to really know what the effects are alone, and/or in combination with AAS. Insulin, diuretics, stimulants, illicit drugs, these are different and effect the body very differently. Some of them certainly can contribute to the disease process when used with AAS. Or used alone.

The smallest dose to achieve the desired effect. Taking into consideration the alternatives, risks, and benefits, of any medicine. All are equally important.