Empower Your Health Conversations with Arya

Dr. Goldman:

Hi Sam, good to see you again. How have you been feeling lately?

Patient:

Hey, thanks. Honestly, pretty good. I've been trying to stick to the new diet and doing 20-minute walks every evening.

Dr. Goldman:

That's great to hear. I reviewed your labs, and I'd like to walk through a few things with you.

Patient:

Sure, go ahead.

Dr. Goldman:

Your total cholesterol came in at 212 mg/dL, which is a bit over the optimal range. Your LDL is at 142, which is up from 127 in your last test about nine months ago.

Patient:

Right. Is that something I should be worried about?

Dr. Goldman:

It's not alarming, but it does mean we may need to intervene a bit more aggressively—especially since your hs-CRP is also slightly elevated at 3.2.

Patient:

That's the inflammation one, right?

Dr. Goldman:

Exactly. High-sensitivity C-reactive protein. It's a marker of systemic inflammation and is often used as a secondary cardiovascular risk indicator.

Patient:

Does the CRP mean I'm at higher risk?

Dr. Goldman:

When combined with your LDL, yes, it could indicate moderate risk. Especially since you mentioned your father had a heart attack in his 50s?

Patient:

Yeah, he was 54. My uncle had one too, I think in his early 60s.

Dr. Goldman:

Family history definitely plays a role here. That kind of early-onset cardiac event increases your baseline risk, even if your lifestyle is otherwise good.

Patient:

Okay, so what do we do now?

Dr. Goldman:

You're already on ezetimibe, which helps block cholesterol absorption. Are you still taking that daily?

Patient:

Yeah, I haven't missed a dose in months.

Dr. Goldman:

Good. I also see a note here that you previously had some muscle soreness when we tried statins?

Patient:

Yeah, I was on atorvastatin for a few weeks and had cramps at night, so I stopped.

Dr. Goldman:

Got it. We could potentially try a lower dose or a different type like rosuvastatin, which some people tolerate better. Or we could consider a coronary calcium scan to stratify your risk further before adjusting meds.

Patient:

Is that like a CT scan?

Dr. Goldman:

Yes, it's a very low-radiation CT that looks at calcified plaque in your arteries. It helps us figure out if there's underlying disease even if your symptoms are minimal.

Patient:

That sounds smart. Is it covered by insurance?

Dr. Goldman:

Sometimes—it depends on your plan. We can have my assistant check for you.

Patient:

Cool, I'm down to do that.

Dr. Goldman:

Great. One more thing: your ApoB wasn't measured in this test, but given your LDL and family history, it might give us more insight into particle count and risk.

Patient:

Okay, can I get that next time?

Dr. Goldman:

Absolutely. I'll add it to your next lab order.

Patient:

Awesome, thanks.

Dr. Goldman:

No problem. Keep up with the walking, and we'll follow up after the calcium score and repeat labs in three months.