Heart failure in steroid using bodybuilders is being misdiagnosed as pneumonia or "bronchial infection" because doctors unfamiliar with bodybuilding see inflamed lungs with fluid in them and this is pneumonia.
Problem is its also part of the edema from heart failure. The only ways to check for heart failure are echocardiograms, angiogram etc. Peripheral edema(swollen ankles, etc.) are early signs yet end stage HF like fluid in lungs is more advanced
Few doctors will run these tests as they are expensive and pneumonia is the most common for a relatively young athletic person to have fluid in lungs.
Dallas McCarver couldn't breathe because of congestive heart failure. They gave him worthless anti biotics and bodybuilding coaches who think they are being responsible by "doing blood work": etc. don't realize blood work often won't catch heart failure.
Most bodybuilders know nothing of heart failure and frequently confuse it with a heart attack.
A heart attack is when the arteries to the heart are blocked. Steroids change cholesterol but with proper diet heart attacks can be avoided with diet/meds. It also usually takes years for the atherosclerosis/plaque to build up to that level.
Mike Matarazzo had a heart attack from eating 3 lbs. Of red meat daily with steroids contributing factor.
This kid, Kovacs, Dallas, Big Lenny, and many more are dying from heart failure with reduced ejection fraction. This is from left ventricular hypertrophy with dilated cardiomyopathy.
By the time they cant breathe the fluid has not only swollen the ankles, stomach(ascites), but fluid is now in the lungs. After that comes blood clots and death is near.
Get an echo cardiogram and know ejection fraction. Under 30 EF you're in serious danger zone. Under 20 EF you're going to die without stopping gear. Good news is its reversible since the cause is steroids. This is happening because guys are never going completely off to restore EF.