Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers and writes about medical facts.
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Hello Maarten,
First of all, my compliments for your column, clear to everyone. My wife (60) did a “Health Check” at Phyathai Hospital in BKK last month. An elevated cholesterol was measured there and had to come back last week for a recheck.
I have no doubts about the quality of the doctors, but I do miss the proper explanation with them as we are used to in the Netherlands.
Unfortunately, her cholesterol is still too high and she has been given medication and will come back in 1 month
Values:
- Cholesterol 255mg/dl
- Triglyceride 133 mg/dl
- HDL 66mg/dl
- LDL 187mg/dl
Is this really too high or how should we see it?
A small hole in a heart valve was also found on a heart film.
- No chamber enlargement Good LV sustolic contraction NO RWMA.
- All valve appear normal, except mild TR
- AO=3 cusps, AO>PA
- No clot or vegetation or pericardial effusion were seen.
Here again, no doubt about the doctor, but again little to no explanation, only come back in a month to make a new scan.
Could you give your view on this and what to do if possible, especially with regard to the heart?
There is a lot to find on the internet about cholesterol, how to lower it, etc.
Thanks in advance.
Regards,
J.
******
Dear J.,
Your wife's cholesterol is indeed a little too high. I wouldn't prescribe anything myself, but they will probably want to give her a cholesterol lowering agent, for example simvastatin 10 mg.
Looks like the doctor did an ultrasound of the heart (echocardiogram) and saw a leaky valve on it. Depending on the size, you should treat that or not. She may have had it for years.
Ask him not to use abbreviations in the future. That makes understanding difficult. Cardiologists are no different.
It appears that the leak is in the tricuspid valve between the right atrium and ventricle. That is not very common and could also be an artifact (machine-induced deviation) or a misjudgment. A second opinion is in order here.
My advice: check blood pressure, cholesterol and the valve once a year. If your wife becomes short of breath, have it checked immediately.
It may also be wise to do blood thinning, but that depends on any turbulence (then there is a kind of vortex in the bloodstream). You can also hear how bad the leak is with a stethoscope.
A lot also depends on the age of your wife.
If they want to intervene, ask for a second opinion from another cardiologist anyway, unless there is an emergency, of course.
If there are more questions, let me know.
With kind regards,
Maarten