The abuse of anabolic androgenic steroids (AAS) has remained on the rise despite their well-known deleterious effects. We describe a case of AAS-induced multisystem failure following an extensive history of abuse in a 41-year-old bodybuilder. Furthermore, we review pertinent literature and discuss the different pathophysiologic mechanisms through which AAS affect the heart and other organs. This case points to the possibility of multiorgan involvement and severe cardiac effects of AAS abuse in young individuals who may not have any past medical history.

A young man presented with several days of dyspnoea and delirium due to cocaine use which was confirmed by urine drug screening. Imaging studies confirmed the diagnosis of subcutaneous emphysema, pneumorrhachis and pneumomediastinum. He was managed successfully with conservative therapy.Although a rare clinical finding, cocaine-related pneumomediastinum, subcutaneous emphysema and pneumorrhachis should be recognised early on presentation. This will certainly help to effectively direct the use of healthcare resources and avoid subjecting the patient to unnecessary investigations.

Primary pulmonary vasculature tumors are exceptionally rare, with only a few reported cases. Signs and symptoms of such neoplasms vary but include dyspnea, cough, and chest pain. This condition is associated with a high mortality rate and is easily misdiagnosed as a pulmonary artery embolism. We pre-sent a case of pulmonary artery sarcoma that demonstrates the value of cardiac magnetic resonance imaging for accurate diagnosis.