Brief Answer:
Needs follow up / more tests
Detailed Answer:
Hi friend,
Welcome to Health Care Magic
CHOLESTEROL
There are subdivisions of cholesterol – LDL, HDL, non-HDL and so on.
LDL (& non-HDL) is bad cholesterol – lower, the better.
HDL is good cholesterol – higher, the better.
In the absence of any other risk factor 100 is ideal for LDL-C. In the presence of
ischemia, 70 should be the aim.
Keep weight normal / even a little less
Quit
smoking, if he is a smoker
Regular EXERCISE – say walking or jogging - 30 minutes a day / at least 5 days in a week.
Healthy FOOD is a must. Avoid saturated fats – coconut oil, palm oil, butter, ghee, full cream milk...Avoid junk foods in particular – French fries have palm oil / Pizza has cheese / Indian sweets are made in ghee.../ Change to Poly-un-saturated oil – like sun flower oil. / Include Mono-un-saturated oil – Olive oil.
Repeat the test in 6 weeks.
Cholesterol can still be high, in spite of diet and exercise – you need drugs; Because it is also manufactured in the
liver – and that is determined by heredity.
Statin is the first choice. Some start it straight away – even with normal levels, even without problems (Primary Prophylaxis)
SUGAR
Value after food is borderline
Do GTT and HbA1C
ECG
He needs to be investigated for Coronary
Artery Disease.
When TMT (Treadmill Exercise ECG) suggests ischemia, it is an indication for further work up – because at times, there may be false positive or false negatives. The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary
angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this. [CT angio is non-invasive study for the anatomy. If positive, he will need catheterisation, anyway.]
The aim of any investigation is to modify the treatment, based on the result. Intervention – dilatation with balloon and placing a stent (
Angioplasty) - or CABG (Coronary Artery Bypass Graft) may be advised based on the results.
The treating doctor alone can suggest further based on his assessment of the situation.
Good luck
Take care
Wishing all well
God bless