Introduction:: Coronary artery disease (CAD) represents approximately 390 thousand deaths per year in Brazil and is associated, among other predictors, with the use of anabolic and androgenic steroids (AAS). Objective:: To analyze a clinical case of a patient who suffered AMI after abuse of AAS. A systematic literature review has been carried out to physiologically analyze the main factors that can lead to AMI with the use of these hormones. Methods:: Case Report: The EVR patient, 41 years old, denies any comorbidities or use of medications. He has been admitted to the emergency room due to typical angina-precordial pain in tightness associated with eventual back pain and paresthesia of both upper limbs, after intense physical effort at the gym, without improvement at rest, and with partial improvement after first care at the health unit. The patient was hypertensive in an emergency bed after the occurrence of ST elevation. The patient alleges the use of anabolic steroids for one month. The patient presented with obstructive atherosclerotic coronary artery disease with total occlusion of the anterior descending artery. Systematic review: A total of 89 clinical studies have been compared and submitted to eligibility analysis, with 50 studies selected, according to the PRISMA rules. Results and Conclusion:: AAS can increase protein synthesis, muscle growth, and erythropoiesis. However, abuse of AAS has a toxic cardiovascular effect, which significantly increases the incidence of cardiovascular diseases.

The mortality rate of post-infarction cardiogenic shock (CS) was 80.0-90.0%. Recent studies show a significant reduction of hospital mortality to approximately 50.0%. CS is defined as systemic tissue hypoperfusion resulting from systolic and/or diastolic heart dysfunction, the main cause of which is acute myocardial infarction (AMI). The main predictors are biological markers such as troponin, CKMB and lactate. A systematic literature review and meta-analysis is performed in order to present and correlate the main literary findings on CS and its evolution with possible changes in biomarkers such as troponin, lactate and CKMB. After criteria of literary search with the use of the mesh terms: cardiogenic shock; acute myocardial infarction; biomarkers; troponin; CKMB; lactate; clinical trials and use of the bouleanos “and” between the mesh terms and “or” among the historical findings. In the main databases such as Pubmed, Medline, Bireme, EBSCO, Scielo, etc., a total of 96 papers that were submitted to the eligibility analysis were collated and, after that, 41 studies were selected, following the rules of systematic review - PRISMA (Transparent reporting of systematic reviews and meta-analyzes-http://www.prisma-statement.org/). Some risk factors for its development in AMI are advanced age, female gender, anterior wall infarction, diabetes mellitus, systemic arterial hypertension, previous history of infarction and angina. The CS associated with AMI depends on its extent and its complications, being the main ones: mitral regurgitation, rupture of the interventricular septum and rupture of the free wall of the left ventricule. The diagnosis is based on the clinical manifestations, such as mental confusion, oliguria, hypotension, tachycardia, fine pulse, sweating, and cold extremities; in hemodynamic aspects: systolic blood pressure was < 90.0 mm Hg or 30 mm Hg below baseline, pulmonary capillary pressure was > 18.0 mm Hg and cardiac index was < 2.2 L/min/m2. Laboratory and imaging exams should be requested to evaluate the possible etiology of CS, its systemic repercussions and comorbidities. The treatment aims at the rapid reestablishment of the blood flow in the affected artery, to improve the patient’s prognosis. The biomarkers dosage in the daily clinical practice of the different cardiological centers can facilitate the diagnosis and the conduction of the dubious cases and the best evaluation of the degree of myocardial suffering after CS.

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Introduction: Yamaguchi Syndrome accounts for 15.0-25.0 % of all cases of hypertrophic cardiomyopathies in Japan. In addition, about 54.0 % of patients are symptomatic, including palpitations, dyspnoea, dizziness, syncope and chest pain. Objective: To present a special case of Apical Hypertrophic Cardiomyopathy (AHCM) in a female and Brazilian patient over eighty years old, as well as their recovery with pharmacological treatment. Highlight of Case: The present case report has its notorious importance due to its occurrence in patient without oriental descent; Longevity of the patient demonstrating the efficacy of pharmacological treatment; exhaustion of image evaluation methodologies for diagnosis and therapeutic conduction. Conclusion: The evolution of imaging diagnostic resources has made AHCM evaluation more elaborate, often providing information that helps therapeutical conduction, allowing an increase in survival with a significant improvement in quality of life.

COVID-19 disease is associated with a high inflammatory load that can induce vascular inflammation, myocarditis, and cardiac arrhythmias. Mortality from COVID-19 disease in 2019 is strongly associated with cardiovascular disease, diabetes, and hypertension. These disorders share the underlying pathophysiology related to the renin-angiotensin system (SARS). Cardiovascular disease and SARS pharmacological inhibition increase ACE2 levels, which can increase coronavirus virulence in the lung and heart. On the other hand, there is evidence that coronavirus infection can decrease ACE2, leading to toxic over-accumulation of angiotensin II, which induces acute respiratory distress syndrome and fulminant myocarditis. In addition, there is scientific evidence that SARS-CoV-2 can bind chemically to the heme group of hemoglobin and thus cause the release of iron ions (Fe2+ and Fe3+) that can damage tissues, including the lungs and heart. Another important information is that the heme group is produced by mitochondria and, in this case, the oral or intramuscular use of Coenzyme Q10 (ubiquinone) is strongly recommended, as it stimulates the increase in mitochondrial production. Therefore, the use of chelators of iron ions is notorious, as well as the administration of Coenzyme Q10 as a treatment for patients infected with SARS-CoV-2.