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Dr. Andrew Rynne

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What do these lipid profile reports indicate?

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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 5763 Questions

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Posted on Mon, 16 Apr 2018 in Hypertension and Heart Disease
Question: 81 years old, Caucasian, not over weight, use KETO diet, low blood pressure, CEO of boat building company work 7 days a week, live in China.

Problem, Tightness and pain in the upper chest, both sides, after walking about 1/2 a block. Feels like chest is squeezing together.

Not diabetic, Low BP. Weight 92 kilo, Height 6' 2". Recent lipid results below. Other tests available,

Collected:

03/24/2017 11:59 AM
CHOLESTEROL     189 mg/dL     <=199 mg/dL
TRIGLYCERIDE     117 mg/dL     <=149 mg/dL
HDL     45 mg/dL     >=40 mg/dL
LDL CALCULATED     121 mg/dL     <=99 mg/dL
CHOLESTEROL/HIGH DENSITY LIPOPROTEIN     4.2      <=4.9
CHOLESTEROL, NON-HDL     144 mg/dL     mg/dL

Heart problem? Recent thorough physical including stress test and EKG, attached. No issues evident.

Past problems:
MDS possibly related to Oregano Phosphate poisoning when young. Seems to not be a big problem. HGB continues to slowly decline.

Collected:

03/24/2017 11:59 AM
WBC'S AUTO     7.0 x1000/mcL     4.0 - 11.0 x1000/mcL
RBC, AUTO     3.09 Mill/mcL     4.70 - 6.10 Mill/mcL
HGB     11.7 g/dL     14.0 - 18.0 g/dL
HCT, AUTO     34.1 %     42.0 - 52.0 %
MCV     110.4 fL     80.0 - 94.0 fL
MCH     37.9 pg/cell     27.0 - 35.0 pg/cell
MCHC     34.3 g/dL     32.0 - 37.0 g/dL
RDW, BLOOD     14.7 %     11.5 - 14.5 %
PLATELETS, AUTOMATED COUNT     169 x1000/mcL     130 - 400 x1000/mcL

Ocipical Neuralgia, seems to gone away, I think.
Other tests available.



     
     

     
     

     
     

     
     

     
     

     
     



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doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would recommend performing further tests:

Detailed Answer:
Hello XXXXXXX and XXXX

Thank you for asking on HCM!

I carefully reviewed all your uploaded tests and would explain as follows:

- Your blood lab tests are within the normal ranges, besides a high MCV levels and a little low Hb levels, which could be related to vitamin B12 deficiency. For this reason, I recommend performing vitamin B12 and folic acid plasma levels to exclude this possibility.

- Your blood lipid profile is within the normal ranges, considering LDL/HDL ratio. So, no treatment in needed.

- Your tread mill test has not revealed any presence of coronary artery disease. But, considering submaximal stress level, I would recommend performing further tests to totally exclude coronary artery disease. So, performing one of the tests below would be needed in this regard:

- a cardiac stress echo
- a nuclear perfusional cardiac stress test.

You should discuss with your doctor on the above tests.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 2 days later
Taking 15 mcg vitamin 12 daily, enough?

If general health OK, and no indicators of heart problems, could the chest squeezing be neurological?
doctor
Answered by Dr. Ilir Sharka 33 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

This is a very low dose of vitamin B12, and if vitamin B12 deficiency is proved, you may needed higher doses (injections)to treat the condition properly.

For this reason, I would recommend performing Vitamin B12 plasma levels and discussing with your doctor on the above issues.

Regarding the chest squeezing, it is not typical of any neurological disorders. A possible cervical disc bulging would cause pain in the arms too. But, anxiety can mimic this clinical scenario.

A lung disorder can not be excluded either. For this reason, performing a chest X ray study coupled with pulmonary function tests would help exclude a possible lung disorder.

Another possible cause to consider would be gastro-esophageal reflux. But, in such case, your symptoms would be related to eating.

You should discuss with your doctor on the above issues.

Hope to have clarified some of your uncertainties!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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