valvular hear disease and high cholesterol

 Q: Signs of which valvular heart disease should be looked for in physical examination if a patient has a history of familial hypercholesterolemia?

Answer: Aortic

The aortic valve and root abnormalities due to premature malignant atherogenesis is a complication of familial hypercholesterolemia. For the bedside clinician, it should be of importance to know that a cardiac CT scan is more sensitive than echocardiography to detect aortic valve calcification. Atheromatous plaques in the root and ascending aorta may also be common. Said that mitral valvulopathy can also be present but less prevalent than aortic abnormalities.

#cardiology

References:

1. A. Kawaguchi, C. Yutanid, and A. Yamamoto, “Hypercholesterolemic valvulopathy: An aspect of malignant atherosclerosis,” Therapeutic Apheresis, vol. 7, no. 4, pp. 439–443, 2003. 

2. G.-J. R. T. Kate, S. Bos, A. Dedic et al., “Increased Aortic Valve Calcification in Familial Hypercholesterolemia Prevalence, Extent, and Associated Risk Factors,” Journal of the American College of Cardiology, vol. 66, no. 24, pp. 2687–2695, 2015. 

3. K. L. Chan, K. Teo, J. G. Dumesnil, A. Ni, and J. Tam, “Effect of lipid lowering with rosuvastatin on progression of aortic stenosis: results of the aortic stenosis progression observation: measuring effects of rosuvastatin (ASTRONOMER) trial,” Circulation, vol. 121, no. 2, pp. 306–314, 2010. 

4. C. Pitsavos, K. Toutouzas, J. Dernellis et al., “Aortic stiffness in young patients with heterozygous familial hypercholesterolemia,” American Heart Journal, vol. 135, no. 4, pp. 604–608, 1998.