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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Impact of Hemoglobin Levels and Their Dynamic Changes on the Risk of Atrial Fibrillation: A Nationwide Population-Based Study
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<blockquote data-quote="Nelson Vergel" data-source="post: 256777" data-attributes="member: 3"><p>Not an uncommon complaint here on this forum:</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/tags/palpitations/[/URL]</p><p></p><p></p><p>PALPITATIONS ON TESTOSTERONE</p><p>OPEN ACCESS</p><p>Complex Clinical Cases</p><p></p><p>Elie Kozaily, Bhavana Bangalore, Parth Savsani, Humaira T. Khan, and Maya Guglin</p><p>J Am Coll Cardiol. 2022 Mar, 79 (9_Supplement) 3371</p><p></p><p>Background:</p><p>Palpitations is a common subjective complaint. It tends to be investigated in primary or specialty care clinics. Onset of palpitations after initiation of testosterone replacement therapy in specific patients should raise suspicion for certain conditions.</p><p></p><p>Case:</p><p>A 37-year-old Caucasian man was diagnosed with hypogonadism, with otherwise normal endocrine work-up, after an episode of epididymitis. He developed palpitations 6 months after starting testosterone gel. He was evaluated with echocardiography (ECHO), holter monitor and treadmill stress which were unremarkable. He also reported gray skin and right upper quadrant abdominal pain.He presented a year later with shortness of breath and palpitations that precluded him from working as a machinist in an iron factory. He was found to have atrial fibrillation with elevated troponin and brain natriuretic peptide. After conversion to sinus rhythm, electrocardiogram showed repolarization abnormalities in anterolateral leads. Left heart catheter showed normal coronary arteries. ECHO showed severely reduced right and left ventricular function (ejection fraction 19%). Right heart catheter showed right atrial pressure 19 mmHg, mean pulmonary artery pressure 26 mmHg and pulmonary capillary wedge pressure 18 mmHg. Fick cardiac index was 3.4 L/min/m2.</p><p></p><p>Decision-making:</p><p>Ferritin was elevated to 2,861 ng/mL and iron saturation was incalculable. Cardiac magnetic resonance showed significantly shortened myocardial T2 to 5 milliseconds suggestive of severe iron overload. Plus, hepatic but not splenic iron overload hinted to hereditary hemochromatosis. Genetic testing showed C282Y homozygous mutation for HFE.In addition to iron chelation, patient was initiated on intensive phlebotomy regimen despite hypotension. Symptoms improved notably after few sessions.</p><p></p><p>Conclusion:</p><p>Hypogonadism with concomitant anomalies in young men of Northern European descent should raise suspicion for hereditary hemochromatosis. Early screening and diagnosis before significant cardiac iron overload carries higher chances of reversal of cardiomyopathy.</p></blockquote><p></p>
[QUOTE="Nelson Vergel, post: 256777, member: 3"] Not an uncommon complaint here on this forum: [URL unfurl="true"]https://www.excelmale.com/forum/tags/palpitations/[/URL] PALPITATIONS ON TESTOSTERONE OPEN ACCESS Complex Clinical Cases Elie Kozaily, Bhavana Bangalore, Parth Savsani, Humaira T. Khan, and Maya Guglin J Am Coll Cardiol. 2022 Mar, 79 (9_Supplement) 3371 Background: Palpitations is a common subjective complaint. It tends to be investigated in primary or specialty care clinics. Onset of palpitations after initiation of testosterone replacement therapy in specific patients should raise suspicion for certain conditions. Case: A 37-year-old Caucasian man was diagnosed with hypogonadism, with otherwise normal endocrine work-up, after an episode of epididymitis. He developed palpitations 6 months after starting testosterone gel. He was evaluated with echocardiography (ECHO), holter monitor and treadmill stress which were unremarkable. He also reported gray skin and right upper quadrant abdominal pain.He presented a year later with shortness of breath and palpitations that precluded him from working as a machinist in an iron factory. He was found to have atrial fibrillation with elevated troponin and brain natriuretic peptide. After conversion to sinus rhythm, electrocardiogram showed repolarization abnormalities in anterolateral leads. Left heart catheter showed normal coronary arteries. ECHO showed severely reduced right and left ventricular function (ejection fraction 19%). Right heart catheter showed right atrial pressure 19 mmHg, mean pulmonary artery pressure 26 mmHg and pulmonary capillary wedge pressure 18 mmHg. Fick cardiac index was 3.4 L/min/m2. Decision-making: Ferritin was elevated to 2,861 ng/mL and iron saturation was incalculable. Cardiac magnetic resonance showed significantly shortened myocardial T2 to 5 milliseconds suggestive of severe iron overload. Plus, hepatic but not splenic iron overload hinted to hereditary hemochromatosis. Genetic testing showed C282Y homozygous mutation for HFE.In addition to iron chelation, patient was initiated on intensive phlebotomy regimen despite hypotension. Symptoms improved notably after few sessions. Conclusion: Hypogonadism with concomitant anomalies in young men of Northern European descent should raise suspicion for hereditary hemochromatosis. Early screening and diagnosis before significant cardiac iron overload carries higher chances of reversal of cardiomyopathy. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Impact of Hemoglobin Levels and Their Dynamic Changes on the Risk of Atrial Fibrillation: A Nationwide Population-Based Study
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