Case history
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Évaluation du risque cardiovasculaire en première lignePublished by: Domus MedicaLast published: 2010Cardiovasculaire risicobepaling in de eerste lijnPublished by: Domus MedicaLast published: 2020Case history
A 43-year-old pilot presents for a cardiac stress test required by his employer. He states that there is a strong history of premature cardiac disease in his family and two of his older brothers are currently being treated for high cholesterol. System review is negative except for some mild exertional shortness of breath. Physical examination demonstrates moderate abdominal obesity with a body mass index of 31 kg/m² and waist circumference of 40 inches (102 cm). The remainder of the exam is normal.
Other presentations
Many patients present with symptomatic cardiovascular disease, such as angina, myocardial infarction, transient ischemic attacks, or stroke, and claudication. Patients with very high levels of low-density lipoprotein may present with eyelid xanthelasmas; arcus cornealis with onset before the age of 45 years; and tendinous xanthomas in the Achilles, elbow, and knee tendons as well as over the metacarpophalangeal joints (familial hypercholesterolemia).
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