Lipoprotein (a)

When i went to see the Cardiologist about my PVC's she did a complete cardiac blood work up. Benign PVC's.  All seems quite good except my Lipoprotein a.
I am on 20mg lipitor since April 06    -45 yo F non smoker-father had mild MI at 47 but lived to 72- died from lung cancer-he was a heavy smoker. Granfather had bypass at76-lived to 86.No other family heart disease. Mother has high cholesterol. She is 74 but no problems.
My test results were
Glucose 69
Choles. 163
LDL 73
HDL 68
Tri 112
**LP(a) 164  should be below 30
Homocysteine 9.3
Fib clot  294
Albumin/Creat ratio <3

The Dr wrote in the report to keep LDL under 80 in light of the high LPa, which it is.
The thing that upsets me is in the definition of LPa on the report.  Says :Lp(a) has been found in arteries in places where disease has already begun. Does this mean I have 5 times more plaque than I should for my age?  Should I up the Lipitor to try and lower the LDL more? Should I be checked with a stress test?Thanks-

[CCF-M.D.-MJM]

Hello,

Lipoprotein a questions are always difficult.  Lpa is a risk factor for coronary disease but we aren't quite sure how to treat it.

Does this mean I have 5 times more plaque than I should for my age?

No, it just means that statistically, you are at higher risk to develop coronary disease.

Should I up the Lipitor to try and lower the LDL more?

That is a tough call.  It may not hurt to do that and the data suggests that the lower the LDL, the better.  Remember that lipator decreases your risk of CAD but does not specifically target Lipo a.

Should I be checked with a stress test?

I would still only order stress tests in someone with symptoms, unless I had a strong suspicion for other reasons.  I do not routinely stress test asymptomatic people.

I hope this answers your questions.  Good luck and thanks for posting.

[Beanzz]

I should also add my numbers were not so great before the Lipitor.
Chol. 243
LDL 146
HDL 62
Tri 140

[anacyde]

My husband is on Niaspan for low HDL (his was 32, then 29 at re-check).  He has absolutely zero side effects from the Niaspan, except that he notices he seems to have more energy since being on it.  Not in an anxious way at all, just less lethargy and the desire to get up and do something.

[anacyde]

Interesting you mention worsening on a vegetarian diet.  My total cholesterol dropped, but my HDL plummeted while the LDL stayed basically the same.  My total was 90, my HDL was 19!!!  On a lean meat diet with no trans fat, my total cholesterol is 134, HDL 57.  Two years ago anyway.  I need to have that checked again.

[momto3girls]

Hey there,

Niaspan?  What exactly is that?  My HDL is pretty sucky...only about 29, with LDL of 100.  How do you take it?  My cardiologist suggested I start taking Niacin to bring up the HDL but I know there are side effects to doing so.  I am on fish oil 2 times a day since my endocrinologist thought it would help bump up my HDL and it's actually helped calm my tachy too!  Weird, huh?  Hope you're doing well!

momto3girls

[Mels22]

Mels22
11/08/2006
C15  Al Dente Hi Al,
So sorry to hear about your rough time with health issues! How old are you if you don't mind my asking? It started in your 20s??? Thats crazy, do you have lots of family history? I have a question for you if you don't mind (you seem to be really smart)...
I am 25 - female - had a baby 6 months ago. Since beginning of September, I have had chest pains, shoulder/arm pains, even some in my jaw. I have been to 2 regular MDs, 2 cardiologists, a neurologist and have had chest x-rays, CT scan, MRI, 8 EKGs, blood work, thallium stress test, echo and all came back normal. I still continue to battle my pains and have terrible indigestion/burping/bloating. I also get lots of headaches and feel horribly fatigued all the time. I've had anxiety in the past - on prozac since I was 15. I've had panic attacks but never for this long! My docs say anxiety, GERD, and fibromyalgia but I'm just not convinced. The prilosec seems to be helping some and they just put me on elavil which seems to make me more tired. I don't know what to do! IT is disrupting my life. I have no family history, my HDL and LDL are good, my BP is good. THe only thing thats come back abnormal is my liver enzymes so we are retesting. I need to be back to normal for my husband and baby. My question is, do you think it could be cardiac? All my family and doctors think its just acid reflux and anxiety. What do you think? The cardiologist says there are no more tests he can do except for cath and he doesn't want to do that with my family history and age and risk factors. Let me know and I would appreciate any suggestions!
Thanks and good luck with your health!
Also, for the past couple days, I have had jaw/teeth pain sometimes going up my ear and my nose. Does this sound cardiac? I'm so worried. I do grind my teeth and I suppose it could be TMJ or stress. What do you think? Many things I read online say to go to ER for jaw pain. My question is, if I've been having the jaw pain for several days, if it were cardiac, I would be dead now right? Doesn't jaw pain just start when having the heart attack. I had a regular EKG on Tuesday - good BP and pulse. Do you htink I should have it evaluated? I've had normal stress test, echo, EKGs, blood work, etc. Please just tell me, do you think its cardiac or anxiety or what? I see my regular MD on Tuesday, should I wait til then or go to ER? I would appreciate anyone's input!!!!!!!!!!!!

ps - I'm now on 60 of prozac and 1 mg of ativan. but why the teeth pains?

THANKS!!

[Mels22]

Al,
Thanks for taking out so much time for me!  I'm sorry you are so young with this awful deal.  I don't know if my symptoms are cardiac or not but I would LOVE to find out.  There is no pattern to my pains.  They tend to come on more at night.  Its just a dull ache in my left chest area that comes and goes.  Both my shoulders, arms, and back hurt a lot but it is like fever pains or shooting pains.  The indigestion has gotten a little better with prilosec although I don't know if thats why.  Do you honestly think mine could be cardiac?  That scares me!  No one in my family has had heart problems and my cholesterol is good and so is my BP.  I so far have had no pain with exercise but notice I get more tired.  I don't know if thats being out of shape from having hte baby or what.  I've never been overweight except still trying to get off excess baby weight.  My mom and grandma still healthy and thin.  Everyone thinks I'm crazy for these pains...they are sending me to group therapy cause they think its OCD and anxiety.  I'm just scared everyday of dying and having no one for my baby.  Do you think this is a possiblity?  They won't do anymore tests on me cause they said I'm too young for a cath.  I am having a checkup tomorrow - EKG and blood work but like I said all has come up negative so far.  All doctors think I have fibromyalgia.  My question to you is, are the echo, thallium stress tests, EKGs, blood work and all that a pretty good indication I'm ok.  Those with my age and history and weight, right?  I just don't knwo what to do.  Please advise adn good luck with your health!!!

[Mels22]

Forgot to say, never smoke or drink...eat healthy.  Do you think it could be cardiac?  I don't think they'll give me a 24hour holter but I will ask for one.  They won't let me go back to cardiologist til 3 weeks.  I feel like its a losing battle.
Would appreciate any input!
Thanks!
Good luck with all that you are going through!

[mmfd]

In my opinion, I feel your problems are unlikely to be cardiac.  I would venture a guess that you have some of those pains from carting around a 6 month old baby!  It's always hardest before they begin to crawl and then walk.  They are heavy.  I would also bet that you are not getting enough sleep which is enough to make one feel terrible and have pains and anxiety and arrhythmias, which I don't remember if you have.  Try to calm down and relax and do something nice for yourself every day...you deserve it!