A male patient, who is a house painter and whom you haven't seen in several years, presents with chronic fatigue and mild chest pain frequently relieved by taking a break from painting. He's married to a 47-year-old woman with multiple sclerosis and has two married children and one grandchild living nearby. He also complains of frequent eructation, flatulence, and indigestion after eating. He was told (when he weighed 30 lbs. less than he does now) that he could control his hyperlipidemia by diet.
CC: "I'm always tired, and I have this annoying chest pain when I climb a ladder."
Past medical history: Anxiety, cholecystectomy, vasectomy
Vital signs: Blood pressure (BP): 146/88; height, 6 ft; weight, 242 lbs.
Lab results: TC 230; LDL 180; HDL 32
-What additional subjective data do you think the patient will share?
-What is his 10-year risk assessment according to ClinCalc? Should he be started on lipid-lowering therapy? (Go to the ClinCalc Web site and 'plug in' his data to see what his risk potential is. What do the American College of Cardiology/American Heart Association guidelines suggest about cholesterol treatment?)
-What is your plan of care?
-What additional patient teaching is needed?