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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
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.
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?
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.
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
