
What Does My Lipid Panel Test Report Indicate?

Just had LIPID profile done today. Fasting Sugar is 85. HDL is 32, LDL is 69. Should i be concerned about HDL being too low? I am attaching my reports. Had a MI in December 2016 and a stent was placed. Though LDL and VLDL is low, does HDL being low matter? What could be the reasons? Are the medications affecting?
No treatment required for Hdl more than 30 . Exercise would help
Detailed Answer:
Hello XXXXXXX ,
I went through all the attached reports and the history of medical issues you have had .
All the reports you have attached are pretty much in normal range .
You are non diabetic and Vitamin D is slightly low for which you are already on supplement.
Now coming to you lipid profile .
With Rosagold and diet / lifestyle you lipids are pretty much well under control.
Generally more than 30 Hdl is ok to have in a male patient according to guidelines so we dont need any treatment for the same .
However considering you had an heart issue at a young age the more is always better as Hdl is the good cholesterol we have .
As XXXXXXX our genetic makeup puts Hdl on lower range , one of many reasons heart problems are higher in XXXXXXX .
How would you increase Hdl ?
As I had said no medication is needed for the same at present .
45 mins of aerobic exercise is the best way to increase Hdl. So if that now what you have been doing start with the same .
Stop smoking if you do .
If you drink red wine has flavaniods which increase Hdl . not more than 2 drinks a day ever .
Hopefully i could help .
Regards . Dr. Priyank Mody


Thanks for the response. 2 more questions if you permit:
1) I have been doing brisk walk for 30-40 minutes 5 days a week - is that sufficient or can I now start jogging and running as well?
2) I used to smoke 20 cigs a day before the MI but now I am down to 2. Is that allowed?
3) My LVEF is back to 54% - is that good enough?
Thanks
Smoking even two cigarettes is a big NO
Detailed Answer:
Hello ,
1) The aerobic exercise routine is perfectly ok . Increase upon the speed grafually or you may intermittently jog and walk during the 40 min routine .
2) There is a strict no to smoking . XXXXXXX you have to understand, the only reason you had an heart attack was due to smoking . it disrupted a plaque which was not critical and a blood clot occluded your artery . You have a long life ahead and i am very sure you dont want that episode again . Smoking not increases the chances of tge stent getting chocked but also formation of new blockages . even two cigarette are harmful particularly in your cause . Tide over this habit as soon as you can .
3) Ejection fraction of 54 is as good as normal and it means you had near normal recovery after the MI .
Our only aim would be to prevent any future event and eliminate your risk factors .
Wishing you Good health .
Regards Dr. Mody


Post my MI i hAve enrolled with a dietician and lost weight by 8 KGs - i am 76 kg now from 84 when i had a MI. I have started exercising like i said earlier. Never missed any dose of of medications and doing my lab tests and BP regulary - you have already seen the reports. Smoking i am going to quit altogether shortly. My question is with these changes, how likely can i have another MI? I was told there was a study which said people with MI may live longer than normal becuase they are nore careful - is that correct? What is your opinion? Or is my life shortened because i already had a MI
Yes a healthy lifestyle would reap its benefit in long run
Detailed Answer:
Hello,
If you remove the risk factors and continue with medication, your chances of having another heart issue are similar to a normal healthy individual of your age, as you have achieved near complete recovery from the previous attack with minimal damage to the heart muscle as evident by 54 % EF.
Its no rocket science that if you take more care, the chances of a future attack is far less than someone who is negligent ( Like you were before the MI ).
You are on right track in life towards a healthier old age, the benefit of exercise, maintaining ideal weight and the medication will not only protect you from a future heart problem but also other issues like stroke, hypertension, diabetes, kidney problems and many forms of malignancies.
Thinking a lot about future is also harmful to your health.
So maintain things which are in your hand and continue that indefinitely not just for the 1st 1 or 2 years of a heart problem. Let me know if any further clarification is needed and I would be happy to help.
Regards
Dr. Priyank Mody


I am back - sorry i had to purchase more credits as i have more questions. Hope you don’t mind - i know patients can get irritating sometimes.
Ok so i had my Echo done today. I am attaching the reports. Now what comes out is that my LVEF is 48%. I asked my cardiologist why it dropped from 54% to 48% to which he said i am all normal. Sometimes variations can happen because of different factors in machine and technician etc. But he said my heart had not changed size or enlarged and also the scar is not white. I dont know what that means. I wanted to ask him more questions but he was too busy to answer anything. All he said was that i was Normal and should not worry. But my problem is i want to be normal like i had never had MI not normal with an MI. i hope you understand what i am saying. Please see reports and suggest the change in LVEF - is that worrisome and what could be done to increase that. Also he did not change any medicines - he said keep the meds same and followup after 3 months. Like I said he sounded too busy and hardly gave me 2 mins.
I hope i can rely on you - should i get echo done somewhere else - the same place i did last time and reported 54%? Please suggest
No need for a repeat echocardiogram. Medicine are optimum
Detailed Answer:
Hello ,
I went through the echo report you have posted. It's probably the same territory where you had a heart attack which is contracting slowing. However they haven't mentioned its scarred or dead, so there is a good chance that over a period of 6 months to a year it would improve and you are optimum medication to help you achieve the same.
The artery has been opened and you are on optimum medication so hope for the best.
As your doctor said, echocardiography is a subjective test and there is a difference of 5 % when different people do it. Also, many times technician actually does the echocardiography and so s/he wouldn't correlate it clinically. So get it done from the same person in future so s/he can compare it from the last time. Doing it again now will serve no purpose.
Clinically you are doing good, there is no breathlessness while you walk or chest pain, then as a doctor I wouldn't forsee any problem. A treadmill stress test in future would be adjunctive to echocardiography to monitor recovery or detect any early problem.
Regards
Dr. Priyank Mody


I have a question on my heart rate. My resting heart rate hovers between 60 and 75 - is that fine? Also how much should be my XXXXXXX rate when i exercise. 220- age rule is ok but i am on beta blockers so much should i discount for beta blocker? I just want to make sure my resting and XXXXXXX heart rate are aligned and when i should worry?
Rule of 220 -age is for stress testing and not otherwise in life .
Detailed Answer:
Hello ,
The concept of 220 minus the heart rate doesnt hold true when you are on beta blockers .
Maintain a baseline pulse rate 60 - 7p and with modertae exercise like your walks or jogging to 90 -110 . Again tgese are not rigid number and dont overthink on such things . Just mere thinking that your pulse rate is high will trigger anxoety push it still higher .
Lastly the limits of beta blockade is to optmise the dose of beta blocker to obtain maximum benefit, however its just the pulse but also blood pressure , fatigue and many other clinical parameters you consider while incresing dose .
No amount of physiological increase in pulse is harmful in your case and it would increase with exercise .
Regards Dr. Mody


Beta blocker as a group can hamper sex life , Metoprolol affects the least
Detailed Answer:
Of all the medications you have mentioned , Prolomet witg is a beta blocker can affect your sexual life . Though metoprolol ( prolomet ) is a cardio selective beta blocker and its affect on other system including potency is far less than previous generations of beta blocker , but still of all the medication you have mentioned its the only one . Many a times its anxiety and not the medication which is the culprit .
As you are not on any nitrates or nicorandial , you can take sildenafil , however do discuss it out with your doctor and understand when and how to take it safely.
Regards Dr. Mody

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