Question

CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attach.”

HPI: Mr. Hammond is a 57 year old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feel like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episodes of chest pain. Denies nausea, dyspnea, or light headedness. He was given 0.4mg nitroglycerine tablet sublingual x1 which decreased, but no stopped the pain.

Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (VLDL) 54 mg/dl nitroglycerine tablet sublingual x1 which decreased, but not stopped the pain.

Lipid Panel reveals total cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, very Low-Density Lipoprotein (VLDL) 54 mg/dl

why is hdl considered good?

explain the role inflammation has in the development of atherosclerosis?

Answer 1

1 . High Density Lipoprotein ( HDL) is considered good cholesterol because it carries the bad cholesterol back into the liver from where the detoxification of cholesterol takes place and removed from the body. Therefore, high levels of HDL prevents atherosclerosis , heart related diseases and stroke.

Normal levels of HDL - 40 mg/dl or higher.

Here , in above case Mr. Hammond's HDL level is 31 mg/dl which is lower predisposing him to heart related diseases.

2 . Role of inflammation on atherosclerosis :

Atherosclerosis is a diffuse inflammatory process which results in plaque build up in the blood vessels. The chronic build up of plaque results in stable plaque which impairs the blood circulation resulting in complications. Active inflammatory process results in break up of plaque due to thinning of the fibrous cap. Some people with stable plaque remain asymptomatic while unstable plaque results in symptoms like chest pain which radiates to hand, shoulder, back or even abdomen.

Thank you.