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Case Study: How to Assess and Treat a Patient's Genetic Risk of Coronary Artery Disease?

Course Description
I had a recent case that prompted the question posed in this headline. The patient is a 48-year-old man, previously healthy (on no meds) whose only cardiac risk factor was a family history. (His father had MI at 53, and died several years later.) He presented with a two-week history of exertional angina punctuated by an episode at rest lasting 20 minutes on the day of admission. His initial exam was normal (BMI=24.2; BP=118/70). EKG showed T wave inversion in leads 2 and 3 and aVF. Labs revealed a troponin of 2.32, and lipid panel showed LDL=112, HDL=41, TG=128, and TC=160. He underwent coronary angiography and was found to have a 90 percent proximal RCA lesion, which was treated successfully with a drug-eluting stent.