A 36 year old competitive bodybuilder presented with increasing dyspnoea on exertion over a six week period. He gave a 10 year history of use of anabolic steroids, growth hormone, ephedrine, and thyroxine. Echocardiography demonstrated severe left ventricular hypertrophy and systolic dysfunction. Serum ferritin was normal and there was no serological evidence of viral infection or connective …