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[Coronary heart disease in patients with primary type V hyperlipoproteinemia (author's transl)]
Insights
Primary Type V hyperlipoproteinemia patients have a higher risk of myocardial infarction, even with abdominal pain. Early diagnosis of ischemic heart disease is crucial in these individuals.
Area of Science:
- Cardiology
- Metabolic Disorders
- Lipid Metabolism
Context:
- Primary Type V hyperlipoproteinemia is a rare genetic disorder characterized by elevated levels of very-low-density lipoproteins (VLDL) and chylomicrons.
- Patients often present with recurrent abdominal pain, pancreatitis, and eruptive xanthomas.
- The association between Type V hyperlipoproteinemia and ischemic heart disease is not well-established.
Purpose:
- To report two cases of Type V hyperlipoproteinemia with co-occurring myocardial infarction.
- To highlight the increased incidence of ischemic heart disease in this patient population.
- To investigate the potential role of lipoprotein lipase deficiency in the pathogenesis.
Summary:
- Two patients with primary Type V hyperlipoproteinemia and severe abdominal pain were diagnosed with myocardial infarction.
- Coronary angiography revealed severe three-vessel disease in both cases.
- A selective depression in lipoprotein lipase activity was observed in both patients, suggesting a potential pathogenetic link.
Impact:
- This study suggests a higher incidence of ischemic heart disease in Type V hyperlipoproteinemia than previously reported.
- Clinicians should consider myocardial infarction in patients with Type V hyperlipoproteinemia presenting with severe abdominal pain, regardless of age.
- Further research into the pathogenetic implications of lipoprotein lipase deficiency is warranted.
Abstract:
In two patients with primary Type V hyperlipoproteinemia with typical clinical features including recurrent bouts of abdominal pain a myocardial infarction was diagnosed. In both cases coronary angiography revealed a severe three vessel disease. The case reports demonstrate that the incidence of ischemic heart disease in patients with Type V hyperlipoproteinemia is higher than reported in the literature. In each case of severe abdominal pain, even in younger Type V patients, a myocardial infarction has to be excluded, In both patients a selective depression in the activity of lipoprotein lipase was found. The possible pathogenetic implication of this finding will be discussed.