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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do these lab reports indicate?

Answered by
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Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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Posted on Tue, 29 May 2018 in General Health
Question: Hello doctor,



Can you please evaluate the attached reports and help with the interpretation of

1. High Monocytes

2. Very high Lp(a) lipoprotien

3. PreB Lipoprotien high



My Dad has recently undergone an angioplasty attached are the reports for the same, it was an acute MI
doctor
Answered by Dr. Rishu Saxena 3 hours later
Brief Answer:
follow up.

Detailed Answer:
Thanks for follow up-
1)Monocytes have no significance.Mild to moderate elevation of one out of kany parameters in a clinically stable patient has no significance.
2)High lipoprotein is suggestive of increase cardiac risk in future.
Suggestions-
Exercise daily for 30 minutes.
Eat lots of fibers in diet.
Take lots of fruits and anti oxidants.
Take olive oil in food.

3)Again indicator of future risk of cardiac event.
She can take a statin for few months for prophylaxis.
Atorvastatin 5 mg should taken once daily for 3 months to improve cardiac profile.

Stent of your father is deployed in left anterior descending artery.
Ejection fraction is 30-35%.
Patient is ok i dont think that there is any need to worry.Most likely in 3 months ejection fraction would increase to 40%.
Take home message-
Reports of your mother are not that bad.
Just follow the instruction.

regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rishu Saxena 25 minutes later
Hello Doc

I am a little confused here these reports were of my dad who had undergine an angiopalsty last month

I understood your advice on high lipoprotien and monocytes but not clear on point three which is taking statin for prophylaxis??

As my father is having very low pulse rate around 63 to 65 XXXXXXX and low bp of about 105 70 XXXXXXX

Soo should he take statin??
His current medication is
Ecosprin
Atorva
Ivabrad
Prax 10mg
Please advise
doctor
Answered by Dr. Rishu Saxena 7 minutes later
Brief Answer:
Follow up.

Detailed Answer:
Oh i am sorry i though that reports were of your mother(I had her case in my mind).Your father had a heart attack recently therefore his lipiprotein and monocytes are high.After heart attack a tissue called granulocyte is formed in muscles of heart which are formed by monocytes.Therefore monocytes are on higher side.Its natural and part of pathology of scar formation.
He is already on high dose of statins plus anti coagulant so nothing else is required.
105/70 is not low blood pressure in his case.In a normal person ejection fraction is 60% this means that if 100 ml of blood is reaching heart 60 ml is pumped out (which maintains b.p at 120/80) .Ejection fraction of your fathers heart is somewhat around 30-35% so his b.p would always remain a bit on lower side(Hope you can understand).So in a patient with low ejection fraction criteria of normal blood pressure is different.Above 90 mm of hg systolic is absolutely fine for him.
60-100 is normal range of pulse so he is near lower normal but not in bradycardia.Ivabradine reduces the pulse rate and apart from controlling pulse has no other role in post M.I patient.So it could be stopped now.

I think he is stable doing well and would pick up on next 3 months.
Above answer was peer-reviewed by : Dr. Prasad
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