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Concurrent development of hemiplegia and angina pectoris in a 46-year-old man with familial hypercholesterolemia and
Journal of Atherosclerosis and Thrombosis
|January 1, 1994
Insights
Familial hypercholesterolemia can lead to severe cardiovascular and cerebrovascular events. High lipoprotein(a) levels may contribute to simultaneous angina and stroke in affected individuals.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Genetics
Background:
- Familial hypercholesterolemia (FH) is an inherited disorder characterized by high levels of low-density lipoprotein cholesterol.
- FH significantly increases the risk of premature atherosclerotic cardiovascular disease.
Observation:
- A 46-year-old man with diagnosed familial hypercholesterolemia presented with acute onset of angina pectoris and left hemiplegia.
- Diagnostic angiography revealed a complete occlusion of the right internal carotid artery and a 75% stenosis of the right coronary artery.
Findings:
- The patient exhibited extremely elevated serum lipoprotein(a) [Lp(a)] levels, averaging 62 +/- 2 mg/dl.
- These findings suggest a potential link between severe hypercholesterolemia, elevated Lp(a), and simultaneous major arterial occlusive events.
Implications:
- This case highlights the critical need for aggressive management of lipid disorders in FH patients.
- Elevated Lp(a) may represent a significant, independent risk factor for both coronary artery disease and ischemic stroke in FH.
- Early detection and intervention for high Lp(a) could be crucial in preventing catastrophic cardiovascular and cerebrovascular events.
Abstract:
We report a 46-year-old man with familial hypercholesterolemia who simultaneously developed angina pectoris and left hemiplegia. Angiography revealed complete tapering occlusion of the right internal carotid artery and a 75% stenosis of the right coronary artery. In addition to hypercholesterolemia, his serum Lp(a) levels were very high, with a mean (+/- SE) of 62 +/- 2 mg/dl.