Zain Mustafa, Alsaadi Ahmad Rasheed
Department of Cardiology, Al Assad and Al Mouwasat University Hospitals, Damascus, Syria.
Faculty of Medicine, Damascus University, Damascus, Syria.
Eur J Case Rep Intern Med. 2024 Nov 29;11(12):005043. doi: 10.12890/2024_005043. eCollection 2024.
Hyperlipidaemia is considered one of the most common risk factors for ischemic heart disease. Severely elevated triglyceride levels may lead to hyperviscosity which may contribute to endothelial dysfunction, tissue ischemia and chylomicronaemia. This case report features a 39-year-old, non-smoker male with a past medical history of hypertension and no family history of coronary artery disease, who presented to the clinic with angina. The electrocardiogram and echocardiogram were normal. Laboratory tests were normal except for severely elevated triglyceride levels. A dobutamine stress echocardiogram was positive, so the patient underwent coronary angiography which revealed normal coronary arteries with slow flow in all of the coronary arteries (TIMI 2 flow grade). The patient was then discharged on high-intensity statin, fenofibrate, isosorbide mononitrate, nebivolol, and was given lifestyle modification instructions. After 3 months the patient came back to the clinic for follow-up. He was in good general condition and symptom free. Laboratory tests (including lipid profile) were within normal limits.
Understanding the effects of severely elevated triglyceride levels on coronary endothelial function.Prevention of harmful effects resulting from severely elevated triglyceride levels.
高脂血症被认为是缺血性心脏病最常见的危险因素之一。甘油三酯水平严重升高可能导致血液高黏滞度，进而可能导致内皮功能障碍、组织缺血和乳糜微粒血症。本病例报告的患者为一名39岁不吸烟男性，有高血压病史，无冠状动脉疾病家族史，因心绞痛就诊。心电图和超声心动图正常。实验室检查除甘油三酯水平严重升高外均正常。多巴酚丁胺负荷超声心动图呈阳性，因此患者接受了冠状动脉造影，结果显示冠状动脉正常，但所有冠状动脉血流缓慢（TIMI 2级血流）。随后患者出院，服用高强度他汀类药物、非诺贝特、单硝酸异山梨酯、奈必洛尔，并接受了生活方式调整指导。3个月后患者返回诊所进行随访。他总体状况良好，无症状。实验室检查（包括血脂谱）均在正常范围内。
了解甘油三酯水平严重升高对冠状动脉内皮功能的影响。预防甘油三酯水平严重升高产生的有害影响。
