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Elevated cholesterol and anxiety

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I have a cardiology question.

I am a 42 year old female, good blood pressure, not overweight. My cholesterol is considered elevated but not high (5.8).

About 12 months ago during a routine eye exam with an optomitrist I had a retinal xray. He noted there wwre signs of high cholesterol shown by some dots on the xray. He said this was normally seen in people with very high cholesterol. I went for a blood test and the results were as noted above. My gp at that time did not seem terribly concerned and recommended a follow up test in the future.

Due to the recent death of a friend I am now terribly worried about this and have seen by gp again who has referred me to get new bloods and have a stress echocardiogram.

I am so very concerned that I may have plaque floating around my body or brain and am at suddent risk for a heart attack or strock. I aslo suffer from anxiety which makes it even worse.

I am hoping you could provide some comment,


Category: Family Physician-GP

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.


Thank you for choosing DoctorSpring.

For a person like you with no significant risk factors for cardiovascular disease (I assume you do not smoke either), a value of 5.8 mmol / l Total cholesterol level is near normal. You need not be overly concerned about this just because there was some sings in the retinal examination. This is eye finding is a observational finding and it does not mean all your arteries have plaques.

However it is better to look into the Cholesterol levels and take action if needed. The good thing is that there are very efficient and safe medications if needed. I would like to know whether you have done a Lipid Profile - (Detailed Cholesterol levels which include HDL, LDL, VLDL, TC in addition to Total Cholesterol values.) If so please share the values. You can reply as a followup.

Hope this helps
Feel free to ask followups.

Patient replied :

Thank you for that - was under the impression that the retinal plaque indicated high liklihood of plaque in all other aeteries. One thing I fid not mention is that my father had bypass surgery at 56 but Inam assuming my gender and age make me a little different ?

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.


You have mentioned that " He noted there were signs of high cholesterol shown by some dots on the xray." This is the tricky part here. If this was any pretty evident cholesterol emboli or Hollenhorst plaque I am pretty sure that this the Optometrist would have alerted the Ophthalmologist and your Physician. Also your GP has commented that it is ok. So most likely these are suspicious findings. But if you can get the exact report it will helpful

Now In my opinion this has to be considered as a warning sign. But your total cholesterol is not elevated into any dangerous levels. Nevertheless you should do a complete Lipid Profile (TC, HDL, LDL, VLDL). I am not sure how feasible a repeat opthalmic examination is, but if possible do get it done. This is because if there is a real emboli or plaque you will require some additional testing also.

Your risk is lower than your Father's because of your age and sex. But I would say do no bank of the statistical risk,as it is pointless on an individual level.

Hope this helps
Do keep me posted. Feel free to ask followups.
Thank you

Dr. Deepu Sebin Sebastian
Category: Select Speciality
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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