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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
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 – 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).
