Hyperlipidaemia/Hypercholsteraemia Flashcards
Define hyperlipidaemia
Most commonly, but not exclusively, defined as elevated levels of low-density lipoprotein cholesterol (LDL-C) or non-high-density lipoprotein
How does hyperlipidaemia typically present?
Assymptomatic until significant atherosclerosis has developed
List common complications of hypercholesteraemia due to severe atherosclerosis (7)
Myocardial infarction
Ischaemic cardiomyopathies
Sudden cardiac death
Ischaemic stroke
Claudication
Acute limb ischaemia
Erectile dysfunction
List risk factors for developing hypercholesteraemia
Obesity
T2DM (insulin decreases lipid metabolism in liver)
Hypothyroidism
Cholestatic liver disease (Impairement in bile formation)
Smoking (chronic inflammation increases lipid level and causes oxidative stress)
Nephrotic syndrome (Hypoalbuminaemia causes liver to compensate in other ways such as lipoprotein production)
What family history findings can increase suspicion towards hyperlipidaemia?
Family history of early onset coronary heart disease (e.g. male 1st degree relatives under 55 or under 65 in females)
Most patients with hypercholesterolaemia are not diagnosed until premature cardiovascular disease becomes symptomatic. List 4 examples of such symptoms that should warrant assessment of lipid profiles.
Angina
MI
Stroke
Peripheral vascular diseases
List some of the key diagnostic factors for hyperlipidaemia. (6)
Presence of risk factors (e.g. obesity, diabetes, smoking, hypothyroidism, cholestatic liver disease).
Family history of coronary heart disease
Pmx of cardiac disease such as angina, MI, stroke, peripheral vascular disease.
Consumption of fatty foods and sedentary lifestyle
Excess body weight (especially abdominal obesity)
Xanthelasmas or tendinous xanthomas
What 3 investigations should be ordered in patients suspected of hypercholesteraemia and typical findings.
Lipid profile (Elevated total cholesterol, LDL and triglycerides, low HDL)
serum TSH (elevated in primary hypothyroidism)
Lipoprotein (Elevated)
