I'm Dr Neil Skolnik. Today we are going to talk about the 2023 American College of Cardiology/American Heart Association guidelines for atrial fibrillation (AF). AF is common and is often first identified in the primary care office. AF substantially increases the risk for stroke, dementia, myocardial infarction, and heart failure.
When AF is detected, three areas of care need to be addressed: symptoms, stroke risk, and modifiable lifestyle factors. Patients with AF should have an echocardiogram done as well as laboratory tests (CBC, CMP, and TSH). Stress testing is not routinely needed unless the patient has other indications for a stress test.
We discuss a fascinating case: a 77-year-old man diagnosed with AFib using traditional methods, compared to how this condition is now often identified through smartwatch notifications. This shift raises important questions about the implications of early detection of subclinical AFib — a state where patients are often asymptomatic.
Key Topics Explored:
* The evolution of AFib diagnosis: from symptoms to smartwatch alerts
* The risks and benefits of anticoagulant treatment for subclinical AFib
Predict estradiol, DHT, and free testosterone levels based on total testosterone
⚠️ Medical Disclaimer
This tool provides predictions based on statistical models and should NOT replace professional medical advice.
Always consult with your healthcare provider before making any changes to your TRT protocol.
ℹ️ Input Parameters
Normal range: 300-1000 ng/dL
Predicted Hormone Levels
Enter your total testosterone value to see predictions
Results will appear here after calculation
Understanding Your Hormones
Estradiol (E2)
A form of estrogen produced from testosterone. Important for bone health, mood, and libido.
Too high can cause side effects; too low can affect well-being.
DHT
Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth,
prostate health, and masculinization effects.
Free Testosterone
The biologically active form of testosterone not bound to proteins.
Directly available for cellular uptake and biological effects.
Scientific Reference
Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.
