Case #351: Normal, Healthy, Asymptomatic and At-risk

“Austin,” a 45-year-old male, came to see me in January 2011 at his wife’s request. This is not surprising, considering that men tend to put off seeing a doctor for a variety of reasons. Men are also more likely not to participate in preventive screening and routine visits.

Austin’s CPE (physical exam) showed a normal, healthy male. But his family history was troubling: heart attack, stroke, hypertension and diabetes. His father suffered an MI and died in his late 40s. His maternal grandfather died of a stroke and his paternal grandmother died in her early 50s due to MI. Austin is a non-smoker and non-drinker.

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Case #348: Meet Met Syn

Earlier this year I saw an approximately 50-year-old male whom we hadn’t seen in several years. “Roger” came to our office seeking a checkup.

Roger’s personal medical history is healthy overall. He was not on any medications, is a non-smoker, non-alcohol drinker and regular exerciser. The only family history the patient is aware of is an aunt with Type 2 diabetes.

The patient’s exam was healthy except for waist (weight/BMI), which is a borderline metabolic (met syn) risk factor. The patient’s vitals were:

• Height = 70.5 inches
• Weight = 230 lbs.
• Waist = 39 inches (>=40 is a met syn risk factor for non-Asian men)
• BMI = 32.4 (obese)
• BP = 124/74 (not metabolic by criteria)
• HR = 80

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Case #343: Multiple Risk Factors

“Lauren,” a 52-year-old female, initially presented two years ago with high blood pressure, osteoarthritis, migraine headaches, metabolic syndrome, dyslipidemia and hypothyroidism. Her family history includes a grandfather who suffered a stroke and her mother with Type 2 diabetes and hypertension. Her sister currently has hypertension.

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