cholesterol

As an anesthesia provider should I provide anesthesia for a 48 yo woman, otherwise healthy, with a total cholesterol of 460, LDL 379? She does not want to take chol. lowering medication. She denies any cardiac history herself. EKG is wnl.

[Cleveland Clinic]

It sounds as if she is a heterozygous carrier of the familial hypercholesterolemia gene, which is very closely linked to premature coronary artery disease. The fact that she has a normal EKG only says that she has not had an event yet, but is at very high risk of doing so in the near future. Someone should spend some time to counsel her to take HMG Coa reductase inhibitors as these have conclusively been shown to improve cardiac outcomes in such patients.