Case


Is the following patient is eligible to go on a VLCD?
  • Cadiac Echo:
    • Left ventricle shows mild Concentric Left Ventricular Hypertrophy (LVH), LV distolic dysfunction on Doppler
    • Right Atrium with mild dilatation
    • Fairly good LV systolic Function .60%
  • CKG:  LVH
  • Uric Acid - 9.80 (High), Alkine Phosphitage - 158 (High), P - high, Na - OK


Answer

This patient should be fine.  LVH is not a contraindication and will likely get better with weight loss.  Diastolic dysfunction improves on the VLCD. The elevated uric acid without a history of gout is common.  We do not treat this.  They are strongly encouraged to keep hydrated. —John Hernried, MD, FACP