Cardiovascular System


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M31_F1.jpg"}},{"insert":"\n\n"},{"insert":"Mike is your first patient for the day, returning to your clinic after an initial appointment a month ago.\n\nHe is 52 years old and suffers from diabetes and obesity. With a BMI of 36 and a blood pressure of 140\/80 at his first visit, you had referred him to an endocrinologist to create a dietary plan.\r\n \r\nDiagnosed with metabolic syndrome three months ago, he didn\u0027t think much of it at the time. He stopped smoking at age 35.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M31_F2.jpg"}},{"insert":"\n\n"},{"insert":"His records show a waist circumference (WC) of 120 cm and a total cholesterol of 220 mg\/dL. His HDL was 42 mg\/dL, LDL 139 mg\/dL and triglycerides 210 mg\/dL.\r\n\r\nHe is here today with his wife, Caroline, and their son.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M31_F3.jpg"}},{"insert":"\n\n"},{"insert":"You greet the family and invite them to sit down. \r\n\r\n\u0022Hi, Mike! How\u0027ve you been?\u0022\n\n\u0022Great!\u0022 comes his response, \u0022I\u0027ve been regular with my medication and have been controlling my diet and insulin just as the endocrinologist advised.\u0022\r\n\r\n\u0022I\u0027m also on a regular exercise routine and haven\u0027t had a drink in a couple of months,\u0022 he says proudly.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M31_F4.jpg"}},{"insert":"\n\n"},{"insert":"You express appreciation for his progress, aware that sticking to treatment and diet regimens is far easier said than done. \r\n\r\n\u0022Thanks, doc, it hasn\u0027t been easy!\u0022 he responds, sounding pleased.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M31_F5.jpg"}},{"insert":"\n\n"},{"insert":"But as Mike hands you the results of his latest lipid profile, your jocularity quickly drains.\r\n \r\nHis triglycerides are 160 mg\/dL, HDL 40 mg\/dL, LDL 125 mg\/dL and total cholesterol 290mg\/dL.\n\nYou\u0027re now acutely aware that he has dyslipidemia despite adhering to his dietary and treatment regimens, and will require medication.\r\n\r\nYou proceed to explain the situation to a crestfallen Mike.\n"}]}