Answer with at least 6 sentences, one scholarly reference ( discussion doesn’t have to be long just enough to get the question answered )
Scenario 1: Myocardial Infarction
CC: “I woke up this morning at 6 a.m. with numbness in my left arm and pain in my chest. It feels tight right here (mid-sternal).” “My dad had a heart attack when he was 56-years-old and I am scared because I am 56-years-old.”
HPI: Patient is a 56-year-old Caucasian male who presents to Express Hospital Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states this started this morning and has been getting worse, pointing to the mid-sternal area, “it feels like an elephant is sitting on my chest and having a hard time breathing”. He rates the pain as 9/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, or lightheadedness. Nitroglycerin 0.4 mg tablet sublingual x 1 which decreased pain to 7/10.
Lipid panel reveals Total Cholesterol 424 mg/dl, high density lipoprotein (HDL) 26 mg/dl, Low Density Lipoprotein (LDL) 166 mg/dl, Triglycerides 702 mg/dl, Very Low-Density Lipoprotein (VLDL) 64 mg/dl
His diagnosis is an acute inferior wall myocardial infarction.
Question:
Which cholesterol is considered the “good” cholesterol and what does it do?
The cholesterol considered the “good” cholesterol is high-density lipoprotein (HDL). HDL cholesterol plays a crucial role in cardiovascular health by transporting cholesterol away from the arteries and back to the liver for excretion. This process is commonly referred to as reverse cholesterol transport. HDL cholesterol helps prevent the buildup of cholesterol in the arterial walls, reducing the risk of atherosclerosis and coronary artery disease.
In the given scenario, the patient’s lipid panel shows a low HDL cholesterol level of 26 mg/dl, which is significantly below the desirable range. Low HDL levels are associated with an increased risk of heart disease, as it may not be as effective in removing excess cholesterol from the arteries, potentially leading to plaque formation.
It’s important for individuals to maintain healthy levels of HDL through lifestyle modifications such as regular exercise, a balanced diet, and, if necessary, medication. This can help reduce the risk of myocardial infarction and other cardiovascular events, especially in patients with high-risk factors such as a family history of heart disease. Reference:
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., … & Turner, M. B. (2016). Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation, 133(4), e38-e360. doi:10.1161/CIR.0000000000000350