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Angiogram showed a blockage in one of coronary arteries. History of prostate cancer. Risk of heart disease?

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Practicing since : 2003
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Mr. Soto is a 68 year-old Hispanic male who had recently been experiencing shortness of breath on his morning walk. After seeing his doctor and having a positive stress test, he was admitted to the hospital to undergo an angiogram. The angiogram showed a blockage in one of his coronary arteries, and a stent was successfully placed. After undergoing cardiac rehab, he has come to you to continue his exercise program. His past medical history includes a history of right knee replacement 2 years ago, and a history of stage I prostate cancer treated with radiation 5 years ago.
Lives at home with his spouse, grown daughter and 5 year old grandson
Height: 5’8                                          Weight: 198 lbs                                             
Blood pressure: 110/78                                        
Blood lipids: Total cholesterol: 255 HDL: 35 LDL: 162 Triglycerides: 174
Before his stent, he had been walking five mornings a week for 30 minutes. Since his stent, he has been exercising three times per week in cardiac rehab.

However this is my question Based on the information given, what risk factors does Mr. Soto have for heart disease? What other information might you want to obtain regarding his heart disease risk?
Posted Fri, 30 Nov 2012 in Cancer
Answered by Dr. Jonas Sundarakumar 2 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

Based on the information provided, Mr. Soto appears to have the following risk factors for heart disease:

1) Obesity. His BMI (Body Mass Index) works out to be 30.1, which is indicative of obesity.
WHO classification:
Normal weight = 18.5-24.9
Overweight = 25-29.9
Obesity = 30 or greater

2) Derranged Lipid Profile - Elevated Total Cholesterol; High LDL ("bad" cholesterol); Low HDL ("good" cholesterol); Total/HDL ratio: 7.3 (indicating high risk)

3) Age > 65 years (maximum risk - more than 80% of mortality due to cardio-vascular disease occurs above the age of 65 yrs.)

4) Male sex

5) Race - studies have shown a worse cardiac risk profile in Hispanics compared to non-Hispanic Whites / Caucasians.

Additional information that would be useful in risk assessment for heart disease would be:

- Family history of heart disease
- Smoking or excessive alcohol consumption
- Blood sugar levels
- Any chronic medication
- Excessive stress

Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
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