Question

A 35-year-old man is admitted to the emergency department with chest pain; past history reveals other episodes of this same pain but of a shorter duration. Inquiry into his personal habits reveals that he is a cigarette smoker and that he follows a modified low-fat diet and engages in some regular exercise. His father died of ischemic heart disease at age 45, and other members of his family have had lipid-related disorders. Fasting blood is drawn for chemistry and hematology tests and urine collected for examination. Laboratory results are:

Hemoglobin: 15.0 g/dL

White blood cell count: Mildly elevated

Serum glucose: 120 mg/dL

Serum triglycerides: 300 mg/dL

Serum LDL cholesterol: 150 mg/dL

Serum total cholesterol: 275 mg/dL

Serum enzymes

Aspartate aminotransferase (AST): 60 U/L (normal: 0-45 U/L)

g-Glutamyltransferase (GGT): 70 U/L (normal: 0-45 U/L)

Alkaline phosphatase (ALP): 180 U/L (normal: 0-150 U/L)

Urinalysis

Normal findings

Critical Thinking Questions

1. Which patient issues should be addressed to lower this patient’s risk of a myocardial infarction?

2. What other laboratory tests would be of value?

Answer 1

1.The following patient issues has to be addressed to reduce the risk of myocardial infarction are

• Control the elevated cholesterol level ,especially the LDL which can make an individual to develop atherosclerosis and myocardial infarction overtime

2.The other laboratory tests which could be valued are

• Serum liver profile (because of elevated AST,GT,ALP level
• Cardiac profile
• ECG