Hyperlipidemia

In most patients there is nothing to find on examination. Recognition comes from putting together the history and the laboratory results rather than from physical signs. Common clues: - elevated LDL cholesterol - elevated non-HDL cholesterol - elevated triglycerides - diabetes - hypertension - smoking - chronic kidney disease - family history of early heart disease or stroke - known vascular disease Occasionally severe or inherited disease does show physical signs: - tendon xanthomas — firm lipid deposits in tendons, classically the Achilles tendon or the tendons on the back of the hand - xanthelasma — yellowish deposits around the eyelids - premature corneal arcus — a pale ring around the edge of the cornea, which is meaningful in a younger adult but an ordinary finding in an older one These are not common, but finding one is important and should always be documented and reported. Feeling well does not mean cardiovascular risk is absent. For REx-PN (Canada), items rarely announce the topic in the first sentence. Anchor to objective data, trajectory, and the safest next step for the role...