Case StudiesQuiz 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?
Case StudiesCase 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.
Case StudiesQuiz of the month – January 2022
Take our patient case study quiz specially curated for you by our Faculty Member, Prof. Christopher Cannon.
First published: January 10, 2022
Case Study: David is a 63-year-old man with a 20-year history of hypercholesterolemia and 5-year history of prediabetes. When the hypercholesterolemia was diagnosed, his LDL-C was 256 mg/dL. Since then, he has been managed primarily with high-intensity statin treatment (rosuvastatin 40 mg/d), dietary modification (low saturated fat diet), and daily exercise. One year ago, cardiology workup identified evidence of ASCVD (see chart below). At the time, David’s LDL-C was 162 mg/dL on treatment with maximal dose rosuvastatin, so the cardiologist recommended adding ezetimibe 10 mg qd. After 6 months of treatment, David’s LDL-C fell to 134 mg/dL.
Medical History | Hypercholesterolemia, 20 years Prediabetes, 5 years |
Vitals | Heart rate: 72 bpm Blood pressure: 118/74 mmHg Respiration rate: 18 bpm Temp: 98.6 |
Physical examination | Heart: normal sinus rhythm Lungs: clear to auscultation Extremities: no edema Skin: unremarkable Joints: no tendon xanthomas BMI: 23.5 kg/m2 |
Investigations | Today: Random blood glucose: 103 mg/dL A1C: 5.8% [normal <5.7] eGFR: 77 mL/min/1.73m2 Lipid panel: – LDL-C 134 mg/dL – HDL-C 52 mg/dL – Triglycerides 68 mg/dL – Total cholesterol 176 mg/dL One year ago: CT angiogram: high coronary artery calcium, nonocclusive atherosclerosis |
Medications | Rosuvastatin 40 mg qd Ezetimibe 10 mg qd |
Based on his diagnosis of established ASCVD, the cardiologist identified an LDL-C goal <70 mg/dL and added a PCSK9 inhibitor.
It has been 6 months since he started the PCSK9 inhibitor. He returned to the clinic today for a checkup. Workup identifies LDL-C 47 mg/dL. David reports good adherence to therapy and no side effects of treatment with rosuvastatin 40 mg, ezetimibe 10 mg qd, and a PCSK9 inhibitor.