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Suggest Lab Tests That Are Required Post A Bypass Surgery
Question: Hello Doctor,
I have a family history of my father being operated for bypass surgery.
I had undergone few blood tests which revealed high triglyceride level(319 mg/dL). I am also over weight 102 Kg at age of 35. Kindly suggest me for any further cardiac scans required if any along with the medications.
I have a family history of my father being operated for bypass surgery.
I had undergone few blood tests which revealed high triglyceride level(319 mg/dL). I am also over weight 102 Kg at age of 35. Kindly suggest me for any further cardiac scans required if any along with the medications.
Brief Answer:
please provide more details.
Detailed Answer:
Dear XXXXXXX
Before I could elaborate more one the clinical picture, I would request you to provide more details.
1. Please provide your complete lipid profile including the values of LDL and HDL cholesterol.
2. Please provide your height and your usual blood pressure.
3. Do you take any medication for high blood pressure, diabetes, heart disease or stroke?
4. Do you smoke?
5. What was the age of your father when he was diagnosed to have heart problem for the first time?
6. What is your current life style including the amount of daily exercise and your usual diet pattern?
Waiting for your reply.
Sincerely
Sukhvinder
please provide more details.
Detailed Answer:
Dear XXXXXXX
Before I could elaborate more one the clinical picture, I would request you to provide more details.
1. Please provide your complete lipid profile including the values of LDL and HDL cholesterol.
2. Please provide your height and your usual blood pressure.
3. Do you take any medication for high blood pressure, diabetes, heart disease or stroke?
4. Do you smoke?
5. What was the age of your father when he was diagnosed to have heart problem for the first time?
6. What is your current life style including the amount of daily exercise and your usual diet pattern?
Waiting for your reply.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Before I could elaborate more one the clinical picture, I would request you to provide more details.
1. Please provide your complete lipid profile including the values of LDL and HDL cholesterol.
Ans: Cholestrol total-221.92
Triglycerides: 334.81
HDL: 31.57
LDL: 123.39
VLDL: 66.96
2. Please provide your height and your usual blood pressure.
Height: 172 cm BP: normal
3. Do you take any medication for high blood pressure, diabetes, heart disease or stroke?
No
4. Do you smoke? No
5. What was the age of your father when he was diagnosed to have heart problem for the first time? 67 yrs of age
6. What is your current life style including the amount of daily exercise and your usual diet pattern? Home made food with little or no exercise.
I have also uploaded the latest scan reports for your easy reference.
1. Please provide your complete lipid profile including the values of LDL and HDL cholesterol.
Ans: Cholestrol total-221.92
Triglycerides: 334.81
HDL: 31.57
LDL: 123.39
VLDL: 66.96
2. Please provide your height and your usual blood pressure.
Height: 172 cm BP: normal
3. Do you take any medication for high blood pressure, diabetes, heart disease or stroke?
No
4. Do you smoke? No
5. What was the age of your father when he was diagnosed to have heart problem for the first time? 67 yrs of age
6. What is your current life style including the amount of daily exercise and your usual diet pattern? Home made food with little or no exercise.
I have also uploaded the latest scan reports for your easy reference.
Brief Answer:
please see details below
Detailed Answer:
Dear XXXXXXX
1. One does not derive a risk from parents or family if the first age at diagnosis of coronary heart disease is >55 years for male and >65 years for female relative.
2. Even if I assume your blood pressure to be at highest limit normal i.e. 140 mmHg, your ACC risk score and Qrisk scores do not warrant medicines for cholesterol reduction.
3. For high triglyceride value of 334 mg%, i do not advise any medication to my patient as benefits of such a therapy are not proven. I advise them to lose weight. For a male of XXXXXXX origin with height of 172cm, weight must not be more than 74Kg; ideally it should be around 68Kg. One must avoid all kind of saturated fats including Ghee, Butter, Cream, Full cream milk. Sweets and desserts is a strict NO. Even carbohydrates in form of rice, wheat etc should be reduced. One must exercise regularly. One must walk/ jog daily. One should not consume alcohol at all. After all these measures lipid profile must be repeated after 3 months.
4. Any further cardiac test is only recommended if the subject has any symptoms on walking or exercise or using stairs.
5. Biggest hurdle between you and your good health is your excess weight.
No, any excess calorie can add to your weight and not specifically wheat and rice. Wheat and rice should also be in moderation because any excess will increase triglyceride levels. Triglyceride levels are particularly high if one derives more than 55-60% of your total calories from carbohydrates/ sweets/ cereals. Hence, in these individuals we advise increase in calories from unsaturated fat rather than carbohydrates or cereals. It seems paradoxical but it is true.
Hope this clarifies the issue. Feel Free to discuss further.
Sincerely
Sukhvinder
please see details below
Detailed Answer:
Dear XXXXXXX
1. One does not derive a risk from parents or family if the first age at diagnosis of coronary heart disease is >55 years for male and >65 years for female relative.
2. Even if I assume your blood pressure to be at highest limit normal i.e. 140 mmHg, your ACC risk score and Qrisk scores do not warrant medicines for cholesterol reduction.
3. For high triglyceride value of 334 mg%, i do not advise any medication to my patient as benefits of such a therapy are not proven. I advise them to lose weight. For a male of XXXXXXX origin with height of 172cm, weight must not be more than 74Kg; ideally it should be around 68Kg. One must avoid all kind of saturated fats including Ghee, Butter, Cream, Full cream milk. Sweets and desserts is a strict NO. Even carbohydrates in form of rice, wheat etc should be reduced. One must exercise regularly. One must walk/ jog daily. One should not consume alcohol at all. After all these measures lipid profile must be repeated after 3 months.
4. Any further cardiac test is only recommended if the subject has any symptoms on walking or exercise or using stairs.
5. Biggest hurdle between you and your good health is your excess weight.
No, any excess calorie can add to your weight and not specifically wheat and rice. Wheat and rice should also be in moderation because any excess will increase triglyceride levels. Triglyceride levels are particularly high if one derives more than 55-60% of your total calories from carbohydrates/ sweets/ cereals. Hence, in these individuals we advise increase in calories from unsaturated fat rather than carbohydrates or cereals. It seems paradoxical but it is true.
Hope this clarifies the issue. Feel Free to discuss further.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
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