Case Studies in Lipid Management by D. John Betteridge

By D. John Betteridge

A definitive selection of 35 case reports written by way of opinion leaders within the box of lipid administration, this booklet offers themes of present curiosity starting from vitamin to the most recent pharmaceutical remedies. each one case is a hugely informative examine in line with each one contributor's personal own reviews in the self-discipline of lipids. The publication covers a number of danger elements, sufferers with heart disorder, serious dyslipidemia, mixed hyperlipidemia, secondary lipidemia, and healing matters. It offers a virtually and resource for universal medical occasions and is a vital textual content for practitioners within the box and people in comparable professions.

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Use of statins in women of child bearing age. Lipid Spin 2006; 3: 6–8. qxd 7/24/2006 1:10 PM Page 23 Case 6 A PATIENT WITH DIABETES AND CORONARY HEART DISEASE Mikko Syvänne Case study I was about to start my cardiology evening practice one day in June, 1999, when a worried colleague asked if I could fit in an extra patient on whom he had just performed an exercise test. ‘I’m unsure about the interpretation,’ he said. ’ I encountered a previously healthy 54-year-old man. I learned that he was an architect and an amateur musician, his family presenting world class talent in classical music.

Physical signs The patient was thin, with generalized muscle wasting and a BMI of only 17. She was deeply jaundiced and had striking xanthelasma, extensive planar xanthomas of the palms and soles, and gross hepatosplenomegaly. Tendon reflexes were present and plantar responses were flexor. qxd 7/24/2006 12:09 PM Page 48 CASE STUDIES IN LIPID MANAGEMENT Investigations Hemoglobin was 12 g/dl, with target cells on the blood film. Serum glucose, electrolytes, creatinine, and albumin were all normal but liver function tests were grossly abnormal, with multiple increases above the upper limit of normal in serum bilirubin (> ×15), alkaline phosphatase (> ×10), aspartate transaminase (> ×10), and gamma-glutamyl transpeptidase (> ×30).

The measurement of LDL particle number via apolipoprotein B levels is particularly relevant when there is an increase in more atherogenic small, dense rather than large buoyant LDL particles. 8 mmol/l. The presence of diabetes increases both case-fatality rates with acute coronary syndromes and subsequent long-term prognosis. The patient was categorized as being at high risk after his nonST elevation myocardial infarction, and was treated appropriately with an early invasive strategy with angiography and subsequent stent deployment.

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