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What Are The Findings From Cholesterol Report?

Posted on Thu, 26 Dec 2013

Question: Dear doctor, my father 65 years age undergone executive health check up in a corporate hospital, BIOCHEMISTRY REPORT : CHOLESTEROL-SERUM/PLASMA -211, HDL CHOLESTEROL - SERUM / PLASMA - 50, TOTAL CHOLESTEROL / HDL CHOLESTEROL RATIO - 4.2, TRIGLYCERIDES - SERUM - 146, LDL CHOLESTEROL - SERUM / PLASMA - 132, TMT Test Report - The patient exercised according to the XXXXXXX for 5.04 mins, achieving a work level of XXXXXXX METS: 7.00 resting heart rate of 61 bpm XXXXXXX to a maximal heart rate of 142 bpm. The value represented 91% of the maximal, age-predicted heart rate. The resting blood pressure of 120/80 mm Hg, XXXXXXX to a maximum blood pressure of 200/90 mmHg. The exercise test was stopped due to Fatigue / SOB. CONCLUSIONS: 1) SYSTOLIC HIGH BP RESPONSE 2) NO CHEST PAIN / ARRHYTHMIA 3) AVERAGE EFFORT TOLERANCE 4)TEST IS POSITIVE FOR INDUCIBLE ISCHAEMIA. Based on the above reports 1) What do it mean, test is positive for inducible ischaemia 2) What should be my next step ?

Answered by Dr. T Shobha Deepak (1 hour later)

Brief Answer: Exercise hypertension is marker for future hyperte Detailed Answer: Namaste Welcome to Healthcare-Magic Greetings of the day The treadmill was prematurely terminated because of elevation in systolic blood pressure, which could be due to effort Hypertension(which occurs on exertion). It does not denote presence of clinical hypertension as his resting blood pressure is normal. It only denotes that there is more probability that he will develop hypertension in future as compared to general population. Time for recovery of post exercise systolic hypertension coming back to.normal is more important marker. At present he requires the following Investigation like 1. 2 D echocardiography- if the ejection fraction is normal then there seems to be no cause of concern. Base on lab values he has two abnormality 1. Post prandial blood sugar level is on higher side- it can be.managed by diet control and exercise( 30minutes of brisk walk at a.stretch per day will be the best exercise). 2 . Serum cholesterol levels is high- He will require Statin group of drugs to lower risk factor for ischemic heart disease. I would also suggest reducing on carbohydrates and salt in the diet. Please get in touch with Internal Medicine Specialist to guide and plan further. I hope it helped In case you need any further assistance I will be glad to assist. Wishing you and your family a happy and healthy life. Take care Best Regards Dr T Shobha Deepak MBBS,MD

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. T Shobha Deepak (32 hours later)

Thanks doctor for your valuable suggestions and advise, sending TMT report and final impression given by doctor. 1) It will be helpful ,if you can explain TMT report , in which page, where we can see TMT IS POSITIVE INDUCIBLE ISCHEMIA. 2) If you were in that place, what would be your final impression report. 3) What would you have suggested to patient , in written. Regards, XXXXXXX

Answered by Dr. T Shobha Deepak (1 hour later)

Brief Answer: TMT only shows systolic hypertension Detailed Answer: Namaste Greetings of the day Dear XXXXXXX There is no abnormal tracing of ecg pattern in tmt, the test was terminated basically for systolic hypertension and fatigue. Presence of exercise induced systolic hypertension is marker for development of future hypertension. In the presence of other risk factors for atherosclerosis especially hyperlipidemia it's important to put him on antihypertensive. 2. My final impression would be exercise induced hypertension and hypercholesterolemia. These are independent risk factors for atherosclerosis heart disease. So it's important to treat them individually 3. I would have suggested following -- Brisk walking within tolerable limit, if 30 minutes of brisk walking it's tolerated would have been good --- As previously mentioned by me I would have started on lipid lowering agent like Atorvastatin --- Addition of Antihypertensive like Losartan I hope it helped Will be glad to assist you if you need any further assistance Wishing you and your family a healthy life Take care Best Regards Dr T Shobha Deepak

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Above answer was peer-reviewed by : Dr. Yogesh D