Introduction
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Abstract
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Peripheral artery disease (PAD) is a common manifestation of systemic atherosclerosis affecting 20% of Americans over the age of 801 and over 200 million people worldwide.2 As well as being common, it also carries high mortality and morbidity; and yet, patients with PAD are overlooked on multiple levels. Many go unrecognized in clinical practice.
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A 73-year-old woman with coronary and peripheral arterial disease with hyperlipidemia was referred for a lipidology consult because of elevated liver function tests (LFTs) while on rosuvastatin. Aspartate amino transferase (AST) rose from a baseline of 26 to 120 and alanine amino transferase (ALT) from 15 to 132. She did not drink alcohol nor take other hepato-toxic pharmaceuticals.
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In 2009, a 75-year-old Tsimane man and his wife awoke and went out into the rain forest around their home in the Amazonian lowlands of Bolivia to collect jajata, a palm like plant used to make roofing. Walking home in the afternoon, he collapsed to the ground, unconscious. His wife shook him and after a few minutes he regained consciousness. He complained of chest pain radiating down his left arm. He was having trouble breathing but managed to stand and walk home.
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Introduction
Coronary artery calcium scoring (CACS) was first introduced in the early 1990s as a method for early coronary artery disease (CAD) detection. Since then, there have been significant advancements in CACS from a technological standpoint, but more importantly, continuing compilation of supportive data has led to more widespread use, but certainly not universal acceptance.
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Those born with familial hypercholesterolemia (FH) know better than anyone else that they have a family history of early heart disease.
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Several genetic lipid disorders manifest with physical examination findings in the palms, making it important for lipid specialists to examine the palms of each patient.
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Several genetic lipid disorders manifest with physical examination findings in the palms, making it important for lipid specialists to examine the palms of each patient.
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A 47-year-old, non-smoking man with a history of type 2 diabetes mellitus, elevated lipoprotein(a) [Lp(a)] level, and a family history significant for dyslipidemia and premature coronary artery disease (CAD) presents to clinic for routine medical appointment.


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