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