Dr. Shafi Ullah
Family Physician
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi sir,
I am a 30-year-old male. I am working in an insurance company. No habit of smoking or drinking. My height is 5 feet 10 inches, and weight is 185 lbs.
I have been getting left-sided chest pain for two years. I also have left-sided shoulder pain that radiates into the upper back and left hand pain. I had a CT angiogram last year which was normal. I had an ECG two weeks back which was also normal. When I had a blood test done last week, I got to know my cholesterol levels are too high.
My last cholesterol report is as follows:
1. Total cholesterol - 231 mg/dL (normal range 125 mg/dL to 200 mg/dL).
2. HDL cholesterol- 31 mg/dL (normal range 35 mg/dL to 80 mg/dL).
3. LDL cholesterol - 99 mg/dL (normal range 85 mg/dL to 130 mg/dL).
4. Triglycerides - 590 mg/dL (normal range 25 mg/dL to 200 mg/dL).
5. TC or HDL cholesterol ratio calculated as 7.5 (normal ratio 3.0 to 5.0).
6. LDL or HDL ratio calculated as 3.2 (normal ratio 1.5 to 3.5).
7. VLDL cholesterol calculated as 117.9 mg/dL (normal range 5 mg/dL to 40 mg/dL).
8. Non-HDL cholesterol calculated as 199.9 mg/dL (normal range <160 mg/dL).
I am more anxious about my condition. I am pleased for your advice.
Hi,
Welcome to icliniq.com.
From your query I understood your concern. Epigastric pain radiating to back and shoulders should be evaluated for gastric discomforts like gastritis and cholecystitis which is very common in deranged lipid profile. I believe this is due to hyperlipidemia.
Your lipid profile is out of proportion. You need to bring these values down. Also you need investigations and thorough assessment to rule out other hereditary causes of hyperlipidemia.
Below mentioned measures have to be followed to maintain the cholesterol within range,
Management:
A good and most important start would be to lose weight at least 33 lbs. Your current BMI (body mass index) is 27 which means your are obese, reduce it to less than 25. The key is healthy diet and lifestyle, regular exercise, weight balance, etc.
Choose healthier fat like omega 3, omega 6, mono and polyunsaturated fat (olive oil, canola oil, almonds, walnuts, etc) and say good bye to bad cholesterol like saturated fat. Planning diet with limited fat intake will also help. Make sure that you get no more than 300 mg of cholesterol a day.
Select grains with more fiber such as wheat, pasta, corn flour, etc. Prefer fresh fruits and vegetables. Avoid processed and canned products as well as fries. Eat heart friendly fish with less fat content like tuna, mackerel, salmon, halibut etc.
Avoid alcohol, if impossible keep the intake to minimum and never exceed moderation levels. Avoid smoking. Doing exercise regularly for 45 minutes a day and 250 minutes a week should be your main goal. Artichoke, garlic, oat bran, sitostanol (stigmastanol), blond psyllium, margarines, etc., can help. Lipid lowering agents like statin analogues can be considered too. Talk to your doctor for physical examination and let them help you in this regard.
Investigations to be done
Treatment plan
Preventive measures
Patient's Query
Hi doctor,
Thank you for the reply,
Still, I am feeling chest pain on the left side. I feel very tight and numb over the left shoulder and left upper back side. Also, I have leg pain and weakness. While walking I feel like something is pulling me down. When I lay down or when I sit I am having the same feeling. Very hardly I used to do my routine work. I do not feel comfortable because of the pain. I visited a doctor and he said there is no heart problem. My ECG, TMT, and echo are normal. Please find my enclosed recent blood report. My triglycerides are 610, total cholesterol 180 and vitamin D is 46. I am taking Tonact TG. I underwent an endoscopy and nothing serious in that. I do not have any tension in my house and at work.
Please guide me.
Hi,
Welcome back to icliniq.com.
With normal laboratory reports, chest pain and its radiation to arms is likely attributed to gastric discomfort which is very likely in increased lipid profile. The management of which we discussed in detail in our prior answer and discussion.
Anxiety and stress can be a trigger of chest pain and dizziness can be attributed to that.
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Family Physician
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