Lipid profile needed when there is 1) Obesity 2) Diabetes 3) Hypertension 4) Any one having ischaemic heart disease 5) History of stroke 6) Smoking 7) Family history of dyslipidemia
Hypertension Obesity Diabetes Ischemic heart disease Herditery h/o hyper lipedemia Hypothyroidism
It is highly recommended to take a lipid profile test, as early as age 20. If someone has stroke, diabetes, heart disease and if someone is taking cholesterol-lowering medications, then he needs to take a lipid profile test every year.
* OBESITY.. * HYPERLIPIDEMIA.. * DM .. * HT.. * ENDOCRINE DISORDERS..
It adv for obesity ' Thyroid problem 'IHD ' Diabetes ' hypertension ' chronic liver disease ' renal disease
Over weight... DM. HTN. Coronary Artery disease of heart.
1:-Diseases Linked to High Cholesterol High cholesterol is associated with an elevated risk of cardiovascular disease. That can include coronary heart disease, stroke, and peripheral vascular disease. High cholesterol has also been linked to diabetes and high blood pressure. To prevent or manage these conditions, work with your doctor to see what steps you need to take to lower your cholesterol. 2:-Cholesterol and Coronary Heart Disease The main risk from high cholesterol is coronary heart disease. If the cholesterol level is too high, cholesterol can build up in the walls of your arteries. Over time, this build-up -- called plaque -- causes hardening of the arteries or atherosclerosis. This causes arteries to become narrowed, which slows the blood flow to the heart muscle. Reduced blood flow can result in angina (chest pain) or in a heart attack if a blood vessel gets blocked completely. 3:-Cholesterol and Stroke Atherosclerosis causes arteries that lead to the brain to become narrowed and even blocked. If a vessel carrying blood to the brain is blocked completely, you could have a stroke 4:-Cholesterol and Peripheral Vascular Disease High cholesterol also has been linked to peripheral vascular disease. This refers to diseases of blood vessels outside the heart and brain. In this condition, fatty deposits build up along artery walls and affect blood circulation. This occurs mainly in arteries that lead to the legs and feet 5:-Cholesterol and Diabetes Diabetes can upset the balance between HDL and LDL cholesterol levels. People with diabetes tend to have LDL particles that stick to arteries and damage blood vessel walls more easily. Glucose (a type of sugar) attaches to lipoproteins (a cholesterol-protein package that enables cholesterol to travel through blood). Sugarcoated LDL remains in the bloodstream longer and may lead to the formation of plaque. People with diabetes, especially type 2 diabetes, can have low HDL and high triglyceride (another kind of blood fat) levels. Both of these boost the risk of heart and artery disease 6:-Cholesterol and High Blood Pressure High blood pressure (also called hypertension) and high cholesterol also are linked. When the arteries become hardened and narrowed with cholesterol plaque and calcium, the heart has to strain much harder to pump blood through them. As a result, blood pressure becomes abnormally high. High blood pressure is also linked to heart disease. 7:- obesity 8:-hyperlipdemia 9:- dyslipidemia
Now a days the"Lipid profile" is considered as must after 25 yrs of life without considering male or female.
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Association Between the Frank Sign and Cardiovascular Events Saleh Nazzal, MD; Arnon Blum, MD DISCLOSURES South Med J. 2018;111(8): Abstract Clinicians have attempted to find early preclinical physical diagnosis signs to detect vascular diseases at the preclinical stage and to prevent clinical deterioration in time. An interesting example of such signs is the Frank sign, which was first described by Dr Sonders T. Frank in 1973. Our goal was to summarize the clinical trials and observational studies that had examined the association between the Frank sign and cardiovascular diseases. Summarizing the 57 studies we found showed that this association could be used for early diagnosis of coronary and vascular diseases in the preclinical stage and that they were found in different populations around the world. Autopsy studies also found a strong association between the Frank sign and cardiovascular causes of death in both sexes. Cardiovascular causes of death included ischemic and hypertensive heart disease, calcific valvular stenosis, ruptured dissecting aneurysm of the thoracic aorta, and ruptured atheromatous aneurysm of the abdominal aorta. The Frank sign was correlated with increased intima-media thickness and stroke and was found in patients with peripheral vascular disease and with cardiovascular risk factors. The Frank sign could serve as a physical sign to help clinicians diagnose cardiovascular diseases. Introduction In the last decade physicians have learned to rely on advanced technology to detect subclinical stages of atherosclerosis. Cardiovascular diseases are among the most common causes of morbidity and mortality worldwide. They constitute approximately 31% of all deaths globally every year, or 17.5 million individuals annually. Clinicians have attempted to find early preclinical physical diagnosis signs to detect vascular diseases at the preclinical stage and to prevent clinical deterioration in time. There remains, however, great debate about the accuracy and reliability of such "natural" means. An interesting example is the Frank sign, which was first described by Dr Sonders T. Frank in 1973. It is a diagonal earlobe crease at a 45° angle, in varying depths, that starts from the tragus and extends to the edge of the auricle. Frank made a clinical observation that 19 of 20 patients with the crease had at least one of the known cardiovascular risk factors. The Frank sign can be classified by the length of the crease. It is considered complete when it crosses the entire earlobe, whereas it is considered incomplete when it is visible only partly through the earlobe (Figure 1). The Frank sign also can be evaluated by its depth. Mild is graded when it is visible as a superficial wrinkling on the earlobe, moderate when it is seen as a sulcus with visible base, and severe when the sulcus is so deep that the base is not visible (Figure 2). In addition, a stronger association between the Frank sign and coronary heart disease was found when the sign existed in both ears, not only in one ear.[5–7] Figure 1. The Frank sign classification according to length: complete (A) and incomplete (B). Figure 2. The Frank sign classification according to depth: (A) mild is graded when it is visible as a superficial wrinkling on the earlobe, (B) moderate is graded when it is seen as a sulcus with visible base, and (C) severe is graded when the sulcus is so deep that the base is not visible. The Frank sign has been documented in sculptures from the time of ancient Rome. The earliest work of art is believed to date to the Roman emperor Hadrian (76–138 CE; Figure 3); it was described by Patrakis, who found an association between the Frank sign in this ancient statue and the medical history of Hadrian, who experienced recurrent events of epistaxis and hypertension. Recently, Charlier and Deo identified bilateral earlobe creases in the 1880 death mask of French novelist Gustave Flaubert (1821–1880), who died at age 59 years from brain hemorrhagic stroke, and Galassi et al identified numerous instances of the Frank sign in Renaissance art. Figure 3. Roman emperor Hadrian (76–138 CE). The arrow points to the Frank sign. Our goal was to summarize the clinical trials and observational studies that had examined the association between the physical sign, the Frank sign, and cardiovascular diseases. We searched PubMed and MEDLINE from 1973 to July 2017 using combinations of the following key words: earlobe crease, ear lobe crease, ear-lobe, crease, ear crease, ear creases, and Frank's sign. Randomized controlled trials, original papers, review articles, and case reports were included in the present review. We found 57 papers that summarized clinical observations and clinical retrospective and prospective studies that looked into this interesting association between a physical sign detected during a medical physical examination and the clinical events that follow. In a study that examined 215 Indian patients from different communities, the bilateral Frank sign was significantly associated in patients with documented coronary artery disease (CAD; P < 0.001). The prevalence of the Frank sign increased with advancing age. The combined presence of the Frank sign and ear canal hair represented a more sensitive index of CAD.[5,6] The association between the Frank sign and CAD was studied prospectively among 956 patients with ischemic heart disease who underwent coronary intervention. The Frank sign was associated with ischemic heart disease mainly in patients with more than four cardiovascular risk factors. An increased rate of cardiovascular complications was found following coronary intervention in patients who had a bilateral Frank sign. The first controlled study that examined the relation between the Frank sign and cardiovascular disease found that 47% of 531 patients who had acute myocardial infarction also had the Frank sign (unilateral or bilateral), which is significantly greater than the 30% rate of the Frank sign observed among 305 age-matched control subjects with no clinical evidence of CAD (P < 0.001). A Spanish study found that the association between the Frank sign and CAD was mainly positive and relevant among subjects between the ages of 30 and 60 years. A prospective study that examined 222 patients with CAD found that the prevalence of the Frank sign among patients with coronary disease was significantly higher than those without (82% vs 38.5%). Patients with the Frank sign were prone to develop intraoperative cardiovascular complications (42.6% with vs 4.9% without) and postoperative cardiovascular complications (24.9% with vs 4.9% without). Another prospective study of 286 patients with CAD who underwent coronary angiography because they demonstrated typical symptoms of angina pectoris found that of the 286 patients, 200 had critical stenosis in at least one coronary artery (>50% stenosis). There was a significant higher prevalence of the Frank sign in patients with CAD (72% vs 21%, P < 0.001). The Frank sign was detected in older patients and patients with an increased severity of coronary disease but not with other classic risk factors of coronary disease such as diabetes mellitus, hypertension, smoking, obesity, and hyperlipidemia. Prospective cohort studies found that the Frank sign was associated with increased all-cause and cardiac morbidity and mortality. Patients with the Frank sign had more coronary events and were cautioned to reduce cardiac risk factors, even if they did not have any diagnostic evidence of CAD at the time of examination. The Copenhagen City Heart Study tested the hypothesis that visible age-related signs may be associated with risk of coronary disease, myocardial infarction, and death independent of chronological age. Male pattern baldness, the Frank sign, and xanthelasmata predicted an increased risk of ischemic heart disease and myocardial infarction independent of chronological age and other well-known cardiovascular risk factors. In a Brazilian study of 1464 patients, Tranchesi Júnior et al found that the Frank sign was present in 220 of 338 patients (65%) with CAD (>70% stenosis of ≥1 coronary artery documented by angiography) and that this prevalence was significantly greater compared with patients with the Frank sign but without coronary disease (28% of 1086 patients, P < 0.0001). Both the Frank sign and CAD increased with advanced age (P < 0.0001 for both). This association remained statistically significant in all decades, except for patients older than 70 years. The presence of the Frank sign also was associated with the extent of coronary disease as measured by the number of narrowed major arteries (P = 0.015). The observed sensitivity of the sign for the diagnosis of coronary disease was 65%, with a specificity of 72%, a positive predictive value of 42%, and a negative predictive value of 87%. The Frank sign also was related to the severity of CAD. In stenosis in one to three coronary arteries, the prevalence of the Frank sign increased from 55% (when patients had 1-vessel CAD) to 78% (when patients had 3-vessel CAD, P = 0.015). This association was found in different populations around the world; a significant association between the Frank sign and CAD was found in populations in Croatia, Japan, and Turkey.[20,21] In 2011 an Israeli review described the diagonal earlobe crease as an indicator of ischemic heart disease, and similar results were found by a Chinese group 1 year later. The association between CAD and the Frank sign was studied in 430 individuals without a history of coronary heart disease using coronary computed tomography. The Frank sign was present in 71% of the patients with documented CAD (a 50% stenosis at least in one of the coronary arteries). The prevalence of coronary significant lesions in 307 patients with the Frank sign was 77%, significantly greater compared with 55% of 123 patients without the Frank sign (P < 0.001). The sensitivity, specificity, and positive and negative predictive values for the Frank sign to diagnose any CAD were 78%, 43%, 77%, and 45%, respectively. Adding the Frank sign to the cardiovascular risk assessment of patients with angina pectoris improved the prediction of CAD beyond the Diamond-Forrester classificationDr. Gaurav Chhaya1 Like5 Answers
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*Angina* ☝ *All about*☝ is chest pain, discomfort, or tightness that occurs when an area of the heart muscle receives decreased blood oxygen supply. It is not a disease itself, but rather a likely symptom of coronary artery disease, the most common type of heart disease. The lack of oxygen-rich blood to the heart is usually a result of narrower coronary arteries due to plaque build-up; a condition called atherosclerosis. History The condition was named “hritshoola” in ancient India and was described by Sushruta (6th century BC). Types Stable (or chronic) angina Stable angina occurs when the heart is working harder than usual, for instance, during exercise. It has a regular pattern and can be predicted to happen over months or even years. Rest or medication relieves symptoms. Unstable angina Unstable angina does not follow a regular pattern. It can occur when at rest and is considered less common and more serious because rest and medication does not relieve it. This version can signal a future heart attack within a short time – hours or weeks. Variant and microvascular angina Variant (Prinzmetal’s) angina and microvascular (smallest vessels) angina are rare and can occur at rest without any underlying coronary artery disease. This angina is usually due to abnormal narrowing or relaxation (spasm) of the blood vessels, reducing blood flow to the heart. It is relieved by medicine. Risk factors The following risk factors increase your risk of coronary artery disease and angina: Tobacco use. Chewing tobacco, smoking and long-term exposure to second-hand smoke damage the interior walls of arteries including arteries to your heart allowing deposits of cholesterol to collect and block blood flow. Diabetes. Diabetes is the inability of your body to produce enough insulin or respond to insulin properly. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, which is a form of sugar from foods. Diabetes increases the risk of coronary artery disease, which leads to angina and heart attacks by speeding up atherosclerosis. High blood pressure. Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. Over time, high blood pressure damages arteries. High blood cholesterol or triglyceride levels. Cholesterol is a major part of the deposits that can narrow arteries throughout your body, including those that supply your heart. A high level of the wrong kind of cholesterol, known as low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol), increases your risk of angina and heart attacks. A high level of triglycerides, a type of blood fat related to your diet, also is undesirable. History of heart disease. If you have coronary artery disease or if you’ve had a heart attack, you’re at a greater risk of developing angina. Older age. Men older than 45 and women older than 55 have a greater risk than do younger adults. Lack of exercise. An inactive lifestyle contributes to high cholesterol, high blood pressure, type 2 diabetes and obesity. However, it is important to talk with your doctor before starting an exercise program. Obesity. Obesity raises the risk of angina and heart disease because it’s associated with high blood cholesterol levels, high blood pressure and diabetes. Also, your heart has to work harder to supply blood to the excess tissue. Stress. Stress can increase your risk of angina and heart attacks. Too much stress, as well as anger, can also raise your blood pressure. Surges of hormones produced during stress can narrow your arteries and worsen angina. Causes Angina is usually caused by coronary heart disease. When the arteries that supply your heart muscle with blood and oxygen become narrowed, the blood supply to your heart muscle is restricted. This can cause the symptoms of angina. Angina symptoms are often brought on by physical activity, an emotional upset, cold weather or after a meal. The episodes usually subside after a few minutes. Symptoms Symptoms associated with angina include: Chest pain or discomfort Pain in your arms, neck, jaw, shoulder or back accompanying chest pain Nausea Fatigue Shortness of breath Sweating Dizziness The chest pain and discomfort common with angina may be described as pressure, squeezing, fullness or pain in the center of your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest or feeling like a heavy weight has been placed on their chest. For others, it may feel like indigestion. Diagnosis and test A correct diagnosis for chest pain is important because it can predict the likelihood of having a heart attack. The process will start with a physical exam as well as a discussion of symptoms, risk factors, and family medical history. A physician who is suspicious of angina will order one or more of the following tests: Electrocardiogram (EKG) – records electrical activity of the heart and can detect when the heart is starved of oxygen. Stress test – blood pressure readings and an EKG while the patient is increasing physical activity. Chest X-ray – to see structures inside the chest. Coronary angiography – dye and special X-rays to show the inside of coronary arteries (dye is inserted using cardiac catheterization). Blood tests – to check levels of fats, cholesterol, sugar, and proteins. Treatment and medications Angina treatments aim to reduce pain, prevent symptoms, and prevent or lower the risk of heart attack. Medicines, lifestyle changes, and medical procedures may all be employed. Lifestyle changes recommended to treat angina include: stopping smoking controlling weight regularly checking cholesterol levels resting and slowing down avoiding large meals learning how to handle or avoid stress eating fruits, vegetables, whole grains, low-fat or no-fat dairy products, and lean meat and fish Medicines called nitrates (like nitroglycerin) are most often prescribed for angina. Nitrates prevent or reduce the intensity of angina attacks by relaxing and widening blood vessels. Other medicines may be used such as: Beta blockers Calcium channel blockers ACE (angiotensin-covering enzyme) inhibitors Oral anti-platelet medicines Anticoagulants High blood pressure medications may also be prescribed to treat angina. These medicines are designed to lower blood pressure and cholesterol levels, slow the heart rate, relax blood vessels, reduce strain on the heart, and prevent blood clots from forming. In some cases, surgical medical procedures are necessary to treat angina. A heart specialist may recommend angioplasty. Coronary artery bypass grafting is another standard procedure; this is surgery where the narrowed arteries in the heart are bypassed using a healthy artery or vein from another part of the body. Prevention Unfortunately you can’t reverse coronary heart disease, which causes angina, but you can delay your arteries narrowing. To do this it’s important to: Stop smoking Control high blood pressure Reduce your cholesterol level Be physically active Achieve and maintain a healthy weight Control your blood glucose if you have diabetes Eat a healthy, balanced dietand only drink moderate amounts of alcohol. Some medications can also be used to help prevent angina episodesDr. Shailendra Kawtikwar5 Likes10 Answers
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45m diabetic on OHA,controlled,bp normal rarely upto140/90 has no any complaints ecg after 5killometer walking routine checkup…… plz expert opinion if there is any future warning…………… history only genetical diabeticsDr. Dinesh2 Likes27 Answers
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60/F presented with h/o developed difficulty in breathing a/w chest discomfort present while on travel consulted elsewhere and admitted for further management.h/o giddiness + k/c/o T2DM, SHTN, Hypothyroidism on rx o/e conscious, oriented, dyspneic HR: 92/min BP:140/90mmhg. SPO2:94% investigation and CAG done.. Diagnosis and treatment?? is possible trop I elevated with normal coronaries??Dr. Nelson Jd3 Likes15 Answers
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POPULAR BELIEF THAT SATURATED FATS CLOG UP ARTERIES 'PLAIN WRONG', SAY EXPERTS. April 25, 2017. British Journal of Sports Medicine (2017). DOI: 10.1136/bjsports-2016-097285 The WIDELY held BELIEF AMONG DOCTORS AND the PUBLIC that SATURATED FATS CLOG UP the ARTERIES, and SO CAUSE CORONARY HEART DISEASE, IS JUST "PLAIN WRONG," contend experts in an editorial published online in the British Journal of Sports Medicine. IT'S TIME TO SHIFT the FOCUS AWAY FROM LOWERING BLOOD FATS AND CUTTING OUT DIETARY SATURATED FAT, TO INSTEAD EMPHASISING the IMPORTANCE OF EATING "REAL FOOD," taking a BRISK DAILY WALK, AND MINIMISING STRESS TO STAVE OFF HEART DISEASE, they insist. CORONARY ARTERY HEART DISEASE IS A CHRONIC INFLAMMATORY CONDITION which RESPONDS TO a Mediterranean style DIET RICH IN the ANTI-INFLAMMATORY COMPOUNDS FOUND IN NUTS, EXTRA VIRGIN OLIVE OIL, VEGETABLES and OILY FISH, they emphasise. IN SUPPORT OF their ARGUMENT Cardiologists Dr Aseem Malhotra, of Lister Hospital, Stevenage, Professor Rita Redberg of UCSF School of Medicine, San Francisco (editor of JAMA Internal medicine) and Pascal Meier of University Hospital Geneva and University College London (editor of BMJ Open Heart) CITE EVIDENCE REVIEWS SHOWING NO ASSOCIATION BETWEEN CONSUMPTION OF SATURATED FAT AND HEIGHTENED RISK OF CARDIOVASCULAR DISEASE, DIABETES, AND DEATH. And the LIMITATIONS OF the current 'PLUMBING THEORY' are writ large in a series of clinical trials SHOWING that INSERTING A STENT (stainless steel mesh) to widen narrowed arteries FAILS TO REDUCE THE RISK OF HEART ATTACK OR DEATH, they say. "DECADES OF EMPHASIS on the primacy of lowering plasma cholesterol, as if this was an end in itself and driving a market of 'proven to lower cholesterol' and 'low fat' foods and medications, has been MISGUIDED," they contend. SELECTIVE REPORTING OF THE DATA MAY ACCOUNT FOR THESE MISCONCEPTIONS, THEY SUGGEST. A HIGH TOTAL CHOLESTEROL TO high density lipoprotein (HDL) RATIO IS THE BEST PREDICTOR of cardiovascular disease risk, RATHER THAN low density lipoprotein (LDL). And THIS RATIO can be RAPIDLY REDUCED WITH DIETARY CHANGES such as REPLACING REFINED CARBOHYDRATES WITH HEALTHY HIGH FAT FOODS (such as NUTS and OLIVE OIL), they say. A KEY ASPECT of coronary heart disease prevention is EXERCISE, AND A LITTLE GOES A LONG WAY, they say. JUST 30 MINUTES OF MODERATE ACTIVITY A DAY THREE OR MORE TIMES A WEEK WORKS WONDERS for reducing biological risk factors FOR SEDENTARY ADULTS, they point out. And the IMPACT OF CHRONIC STRESS should NOT BE OVERLOOKED because it puts the body's inflammatory response on permanent high alert, they say. All in all, a HEALTHY DIET, REGULAR EXERCISE, AND STRESS REDUCTION will NOT ONLY BOOST QUALITY OF LIFE BUT WILL CURB THE RISK OF DEATH from cardiovascular disease and all causes, they insist. "IT IS TIME TO SHIFT the PUBLIC HEALTH MESSAGE IN THE PREVENTION AND TREATMENT OF CORONARY ARTERY DISEASE AWAY FROM MEASURING SERUM LIPIDS AND REDUCING DIETARY SATURATED FAT," they write. "CORONARY ARTERY DISEASE is a CHRONIC INFLAMMATORY disease and it can be REDUCED EFFECTIVELY BY WALKING 22 MINUTES A DAY AND EATING REAL FOOD." But, they point out: "THERE IS NO BUSINESS MODEL OR MARKET TO HELP SPREAD THIS SIMPLE YET POWERFUL INTERVENTION." $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ ____________________________________ MORE INFORMATION: Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions, British Journal of Sports Medicine (2017). DOI: 10.1136/bjsports-2016-097285 ____________________________________ PROVIDED BY: British Medical Journal ____________________________________ IMAGE : Human heart. CREDIT: copyright American Heart Association ***************************+*******************************Dr. Puranjoy Saha17 Likes11 Answers