Case Studies

  • Case Studies

    August 2023

    Take this short quiz to test your knowledge on the recently published debate on dyslipidemias titled “Great debate: lipid-lowering therapies should be guided by vascular imaging rather than by circulating biomarkers”.

    CLICK HERE TO VIEW THE DEBATE.

    Eur Heart J. 2023 Jul 1;44(25):2292-2304. doi: 10.1093/eurheartj/ehad275

    Prof. Lale Tokyozoglu, Prof. David Morrow, Prof. Stephen Nicholls

    First published: August 22, 2023  

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  • Case Studies

    Quiz of the month – July 2023

    Poll Question

    First published: July 12, 2023  

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  • Case Studies

    Quiz of the month – June 2023

    Poll Question

    First published: June 9, 2023  

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  • Which, if any, of the following social media networks do you use for medical information? Select all that apply.

  • Case Studies

    Quiz of the month – May 2023

    Take this short quiz to test your knowledge on some of the latest peer-reviewed published literature related to ASCVD and Lipidology.

    First published: May 15, 2023  

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  • Case Studies

    Quiz of the month – April 2023

    Take our patient case study quiz specially curated for you by our Faculty Member, Prof. Samer Ellahham.

    Prof. Samer Ellahham

    First published: April 17, 2023  

    Case Study: A 65-year-old man with a history of dyslipidemia, type 2 diabetes mellitus and systemic hypertension.

     

    Presentation:

    New onset crescendo angina x 5 days culminating

    Rest pain for the past 2h

    No history of other vascular events or heart attack, no TIA or stroke

    Weight: 90 kg

    Exam: BP 150/85 (slightly elevated), Heart Rate 80

    No murmur detected

     

    Medication:

    Valsartan 160 mg daily, Aspirin 81 mg daily, Rosuvastatin 10 mg daily, Metformin 500 mg twice daily

     

    Labs:

    BMI 31kg/m2, waist circumference 101.6 cm (40 inches), (-) tobacco (quit last year – 60-pack-year history)

    Normal CBC, electrolytes

    Troponin: Elevated

    Electrocardiogram:1-2 mm horizontal ST depression infero-lateral leads

    Chest X-ray: Normal

     

    Lipid panel:

    Total cholesterol (TC) 192 mg/dL

    HDL-C 46 mg/dL

    Triglycerides 180 mg/dL (non-fasting)

    LDL-C 110 mg/dL

    Non-HDL-C 146 mg/ dL

     

    What are the first impressions about this patient?

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  • Case Studies

    Quiz of the month – March 2023

    As an HCP would you use a plain language infographic as a tool to explain atherosclerosis and lipid lowering to your patients?

    First published: March 15, 2023  

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  • Case Studies

    Quiz of the month – February 2023

    Take our patient case study quiz specially curated for you by our Faculty Member, Prof. Stephen Nicholls.

    Case Study: A 58-year-old overweight man with a 10-year history of primary hypercholesterolemia presents for a checkup. At diagnosis of hypercholesterolemia, his LDL-C was 198 mg/dL; his clinician recommended diet and exercise interventions and started atorvastatin 10 mg qd. The patient follows a low saturated-fat diet and exercises daily. However, he could not tolerate higher doses of atorvastatin or rosuvastatin 5 mg or pravastatin 20 mg. Today, his LDL-C is 138 mg/dL, HDL-C 52 mg/dL, and triglycerides 78 mg/dL. He continues to take atorvastatin 10 mg qd.

    You add ezetimibe, and follow-up bloods a month later show an LDL-C of 108 mg/dl. You are not sure if he has ASCVD, so review of prior imaging shows he had a CT scan a year ago to evaluate shortness of breath, and the report comments that he has “moderate coronary artery calcification”. You check and Lp(a) and it is elevated at 200 nmol/L (upper limit of normal is 75 nmol/L).

    Prof. Stephen Nicholls

    First published: February 2, 2023  

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  • Which of the following might be appropriate at this time?

  • Case Studies

    Quiz of the month – January 2023

    Poll Question

    First published: January 11, 2023  

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  • Case Studies

    Case Study – December 2022

    Our patient case study specially curated for you by our Faculty Member, Prof. Samer Ellahham on concerns about statin associated Diabetes Mellitus.

    Prof. Samer Ellahham

    First published: December 9, 2022  

    Case Study: RS is a 64-year-old Male having dyslipidemia.

     

    Vital parameters:

    BP 144/87 mm Hg

    Low-density lipoprotein cholesterol (LDL-C) 112 mg/dL

    High-density lipoprotein cholesterol (HDL-C) of 47 mg/dL

    Triglycerides 190 mg/dL

    (-) tobacco, (-) alcohol

    Body mass index (BMI) 33 kg/m2

     

    Medication:

    Valsartan 80 mg/d

     

    Family history:

    Father developed type 2 diabetes mellitus (T2DM) and ASCVD at age 58

     

    Labs:

    Fasting blood glucose 103 mg/dL

    HbA1C 5.8%

    Serum Creatinine 1.1 mg/dL

    Urinary analysis within normal limits

     

     

    RS reports that he is reluctant to take statins as they cause diabetes especially with his family history.

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  • Case Studies

    Quiz of the month – November 2022

    Take our patient case study quiz specially curated for you by our Faculty Member, Prof. Chern-En Chiang.

    Prof. Chern-En Chiang

    First published: November 8, 2022  

    Case Study: A 48 y male patient presented with anterior chest pain for 1 hour. He was sent to ER where acute anterior ST-elevation MI was diagnosed. Emergent cardiac catheterization demonstrated a 30-40% stenosis over left main artery, a 100% occlusion over middle portion of left anterior descending artery, 90% stenosis over middle portion of right coronary artery, and a 50% stenosis in the proximal portion of left circumflex artery. Two DES were implanted uneventful: one on LAD and the other on RCA. Echocardiogram revealed an LVEF 52% with mild hypokinesis over LV anterior wall.

     

    Past history:

    Type 2 diabetes for 5 years with metformin 1000 mg/d

    Hypercholesterolemia under rosuvastatin 10 mg/d

    Denied history of HT

    No smoking history

     

    Family history:

    Strong family history of premature CVD (His father died of MI at the age of 58. His grandfather died of MI at the age of 65, and his uncle has TVD.)

     

    Before discharge:

    BMI 25

    BP 128/76 mmHg, HR 76/min

    eGFR 76 ml/min, Na 141 meq/L, K 4.1 meq/L

    HbA1c 7.1%

    LDL-C 124 mg/dL, HDL-C 42 mg/dL, triglyceride 210 mg/dL, Lp(a) 105 mg/dL

     

    Discharge medications:

    Aspirin 100 mg QD, ticagrelor 90 mg BD, bisoprolol 5 mg QD, metformin 850 mg BD, dapagliflozin 10 mg QD, rosuvastatin 20 mg QD, ezetimibe 10 mg QD

     

    3-month follow-up clinic:

    No symptom

    BMI 24

    BP 120/72 mmHg, HR 66/min

    eGFR 72 ml/min, Na 144 meq/L, K 4.2 meq/L

    HbA1c 6.4 %

    LDL-C 77 mg/dL, HDL-C 48 mg/dL, triglyceride 198 mg/dL, Lp(a) 108 mg/dL

     

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  • What are your next steps? (multiple choice)

  • Case Studies

    Quiz of the month – October 2022

    Take this short quiz to test your knowledge on the recently published infographics titled “Role of Lipoprotein(a) in Atherosclerotic Cardiovascular Disease and Aortic Stenosis” and “Therapeutic Management of Dyslipidemia: New Strategies”.

    First published: October 28, 2022  

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  • Case Studies

    Quiz of the month – September 2022

    How many patients with ASCVD do you treat per week?

    First published: September 23, 2022  

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  • How many patients with ASCVD do you treat per week?