Cracked heart with scattered pills, symbolizing the cardiovascular risks of steroid use.

Steroid Use and Your Heart: Understanding the Hidden Risks

Theo Raines in Health & Wellness November 2025 • 4 min read.

"A Rare Case Study Reveals the Unexpected Cardiovascular Dangers of Long-Term Steroid Therapy"

Corticosteroids are powerful medications widely prescribed for managing various inflammatory and immunological conditions. From easing arthritis pain to suppressing autoimmune responses, steroids offer significant relief to millions. However, like any medication, they come with a range of potential side effects, some of which can be quite serious.

While many are aware of the common side effects like weight gain, mood changes, and increased risk of infection, the cardiovascular complications of long-term steroid use are often overlooked. A recent case study highlights a rare but potentially fatal consequence: ventricular septal rupture (VSR).

This article explores this unusual case, shedding light on the hidden cardiovascular risks associated with chronic steroid use and emphasizing the importance of vigilance in patients undergoing long-term treatment.

Ventricular Septal Rupture: A Rare but Deadly Complication

Cracked heart with scattered pills, symbolizing the cardiovascular risks of steroid use.

Ventricular septal rupture (VSR) is a rare but life-threatening condition involving a tear in the wall separating the heart's two ventricles. This defect allows blood to flow abnormally between the ventricles, reducing the heart's efficiency and potentially leading to heart failure.

While VSR is most commonly associated with heart attacks, it can also occur as a complication of other conditions, including chronic steroid use. The case study presented in the medical journal Chest details a 64-year-old woman with a history of hypertension, hyperlipidemia, diabetes, and focal segmental glomerulosclerosis, who developed VSR after 10 years of immunosuppressive therapy with steroids following a kidney transplant.

The Patient's Presentation: The woman presented with acute central chest pain radiating to her back, accompanied by nausea, vomiting, and shortness of breath.
Initial Findings: Despite her symptoms, initial vital signs and physical examination were essentially normal. However, her initial troponin level, a marker of heart damage, was significantly elevated at 4.32 ng/ml.
Diagnostic Tests: An electrocardiogram revealed sinus rhythm, a regular heart rate, a new left bundle branch block, and ST elevation in leads V2 and V3, suggesting a heart attack. An emergent coronary angiogram showed normal coronary arteries but revealed a large apical ventricular septal defect (VSD). An echocardiogram confirmed an ejection fraction (EF) of 45%, concentric left ventricular hypertrophy, a dyskinetic apex, a dyskinetic distal 1/3 of the anteroseptal wall, and an apical VSD measuring 1.4 cm with left-to-right communication.
Clinical Course: The patient's condition deteriorated, leading to cardiac arrest and respiratory failure. Despite resuscitation efforts, her family opted for comfort care, and she ultimately passed away.

This case underscores the potential for long-term steroid use to contribute to severe cardiovascular complications, even in individuals with seemingly normal coronary arteries.

Protecting Your Heart While Using Steroids: What You Need to Know

If you are taking corticosteroids long-term, it's crucial to be aware of the potential cardiovascular risks and take proactive steps to protect your heart health. Regular check-ups with your doctor are essential, including monitoring blood pressure, cholesterol levels, and blood sugar. Discuss any new or worsening symptoms, such as chest pain, shortness of breath, or swelling, promptly. By staying informed and working closely with your healthcare team, you can minimize your risk and maintain a healthy heart while managing your underlying condition.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.chest.2018.08.085, Alternate LINK

Title: Ventricular Septal Rupture: A Rare Fatal Complication Of Chronic Steroid Use

Subject: Cardiology and Cardiovascular Medicine

Journal: Chest

Publisher: Elsevier BV

Authors: Naga Sai Shravan Turaga, Eric Lee, Shashitha Gavini, Krishna Nagendran

Published: 2018-10-01

Everything You Need To Know

What cardiovascular risks are associated with long-term steroid use, and why is ventricular septal rupture (VSR) a concern?

Long-term use of corticosteroids can lead to several cardiovascular complications, one of the most severe being ventricular septal rupture (VSR). While common side effects like weight gain and mood changes are well-known, the risk of VSR, where a tear occurs in the heart's ventricular wall, is often overlooked. This condition can reduce the heart's efficiency and lead to heart failure. Although VSR is frequently associated with heart attacks, this case highlights that it can also arise from chronic steroid use, emphasizing the need for vigilance.

What is ventricular septal rupture (VSR), and how does it impact the heart's function?

Ventricular septal rupture (VSR) is a rare but critical condition where a tear develops in the septum separating the heart's ventricles. This tear allows blood to flow abnormally between the ventricles. The irregular flow compromises the heart's ability to pump blood effectively, potentially leading to heart failure. While VSR is commonly linked to myocardial infarction, the presented case illustrates it can also be a consequence of long-term steroid use, even in individuals without significant coronary artery disease.

What were the initial symptoms and findings that led to the diagnosis of ventricular septal rupture (VSR) in the patient described?

In the case presented, the patient initially presented with acute central chest pain radiating to her back, accompanied by nausea, vomiting, and shortness of breath. Despite these severe symptoms, her initial vital signs and physical examination were relatively normal. However, a key finding was a significantly elevated troponin level, a marker indicating heart damage. Subsequent diagnostic tests, including an electrocardiogram and coronary angiogram, revealed a large apical ventricular septal defect (VSD). An echocardiogram further detailed the extent of the damage, showing reduced ejection fraction and other abnormalities.

What steps can individuals taking corticosteroids long-term take to protect their heart health and minimize cardiovascular risks?

To safeguard your heart health while undergoing long-term treatment with corticosteroids, regular check-ups with a healthcare provider are crucial. These check-ups should include monitoring of blood pressure, cholesterol levels, and blood sugar. It's important to promptly discuss any new or worsening symptoms, such as chest pain, shortness of breath, or swelling. By remaining vigilant and collaborating closely with your healthcare team, you can minimize the risks associated with long-term steroid use and maintain cardiovascular well-being. Monitoring ejection fraction via echocardiograms is also important.

How does focal segmental glomerulosclerosis and subsequent kidney transplant relate to the cardiovascular complications observed with long-term steroid use?

Focal segmental glomerulosclerosis, present in the patient in the case study, is a kidney disease characterized by scarring in specific sections of the glomeruli, which are the filtering units of the kidneys. The disease progression can lead to kidney failure, often necessitating treatments such as kidney transplantation. Following a kidney transplant, immunosuppressive therapy, including steroids, is commonly prescribed to prevent rejection of the new organ. However, the long-term use of these immunosuppressants, as demonstrated in the case, carries potential cardiovascular risks, underscoring the importance of careful management and monitoring in transplant recipients.