A 57-year-old patient had an acute myocardial infarction and has a blood test with cholesterol 312 mg/dl, LDL 241 mg/dl, HDL 29 and normal TG. He smoked 30 cig/day, was not obese, his blood pressure was 145/90 mm Hg and he did not have diabetes. When asked about family history, he mentioned that an uncle on his mother's side died suddenly at 53 years of age. Which answer do you agree with the most?
Question on a fashionable topic in recent years: dyslipidemia; I would answer it by rule out. The treatment for hypercholesterolemia is statins so we rule out answers 2 and 4. The statin in a patient with cardiovascular disease (such as an AMI) is a lifelong treatment (we discard 1) since it is not taken until LDL levels are normalized. Between 3 and 5, 5 is more complete as it includes treatment and control of other risk factors. Ruling out secondary dyslipidemia is easy with the patient's clinical history and a blood test with thyroid function.
Treat with statins until cholesterol is normalized and recommend healthy lifestyle (diet, exercise and no smoking).
Rule out hypothyroidism or other systemic disease, recommend a healthy lifestyle and treat with fibrates to normalize cholesterol.
It is not necessary to rule out secondary dyslipidemia because it is infrequent. A family lipid profile should be performed.
Rule out secondary dyslipidemia, treat with resins (resincholestyramine) and fibrates and re-commend a healthy lifestyle. Prohibit alcohol.
Rule out secondary dyslipidemia, request a family study and treat with statins to maintain a good lipid profile. Control of other risk factors.
The statin in a patient with cardiovascular disease (such as an AMI) is a lifelong treatment (we discard 1) since it is not taken until LDL levels are normalized.
The treatment for hypercholesterolemia is statins so we rule out answers 2 and 4.
Between 3 and 5, 5 is more complete as it includes treatment and control of other risk factors.
The treatment for hypercholesterolemia is statins so we rule out answers 2 and 4.
Between 3 and 5, 5 is more complete as it includes treatment and control of other risk factors.