Skip to Main Content
Home Books Quick Dx & Rx: Cardiology

Obesity and Heart Disease

  • Sections
  • Print
  • Get Citation

    Citation

    Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy.

    AMA Citation
    Obesity and Heart Disease. In: Crawford MH, Aras M, Sanchez JM. Crawford M.H., & Aras M, & Sanchez J.M.(Eds.),Eds. Michael H. Crawford, et al.eds. Quick Dx & Rx: Cardiology. McGraw-Hill; Accessed July 05, 2020. https://accesscardiology.mhmedical.com/content.aspx?bookid=2470&sectionid=196387112
    APA Citation
    Obesity and heart disease. Crawford MH, Aras M, Sanchez JM. Crawford M.H., & Aras M, & Sanchez J.M.(Eds.),Eds. Michael H. Crawford, et al. (2018). Quick Dx & Rx: Cardiology. McGraw-Hill. https://accesscardiology.mhmedical.com/content.aspx?bookid=2470&sectionid=196387112
    MLA Citation
    "Obesity and Heart Disease." Quick Dx & Rx: Cardiology Crawford MH, Aras M, Sanchez JM. Crawford M.H., & Aras M, & Sanchez J.M.(Eds.),Eds. Michael H. Crawford, et al. McGraw-Hill, 2018, https://accesscardiology.mhmedical.com/content.aspx?bookid=2470&sectionid=196387112.

    Download citation file:

    RIS (Zotero)
    EndNote
    BibTex
    Medlars
    ProCite
    RefWorks
    Reference Manager
    Mendeley
    © Copyright
  • Tools
  • Search Book
  • Clip
Top

KEY FEATURES

ESSENTIALS OF DIAGNOSIS

  • Body mass index > 30 kg/m2

  • Increased left ventricular mass by imaging in the absence of hypertension or diabetes

  • Heart failure and cardiac arrhythmias common

GENERAL CONSIDERATIONS

  • Obesity is not only a risk factor for coronary artery disease, but can also cause left ventricular hypertrophy, heart failure, and arrhythmias independent of hypertension

  • Fatty infiltration of the conduction system and sleep apnea have been found in obese individuals; both can lead to arrhythmias

  • Eccentric left ventricular hypertrophy may be related to increased plasma volume and metabolic demands

  • Obesity is also part of the metabolic syndrome, which predisposes to atherosclerosis

CLINICAL PRESENTATION

SYMPTOMS AND SIGNS

  • Dyspnea and fatigue are common

  • Chest pain and palpitations can occur

PHYSICAL EXAM FINDINGS

  • Increased body mass index:

    • – Obese > 30 kg/m2

  • Central (truncal or android) obesity (waist circumference > 102 cm men, > 88 cm women) is a risk factor for atherosclerosis

  • Lower body (gynecoid) obesity is not a risk factor for coronary artery disease

  • Systemic hypertension

  • Left ventricular lift or heave

  • Signs of heart failure may be present

  • S3 or S3 may be present

DIFFERENTIAL DIAGNOSIS

  • Coronary artery disease

  • Dilated cardiomyopathy

  • Hypertrophic cardiomyopathy

  • Diabetic cardiomyopathy

DIAGNOSTIC EVALUATION

LABORATORY TESTS

  • Elevated lipids

  • Abnormal liver function tests from fatty accumulation

ELECTROCARDIOGRAPHY

  • Prolonged QTc

IMAGING STUDIES

  • CT and MRI: useful to confirm excess internal fat accumulation

  • Echocardiography:

    • – Shows left ventricular hypertrophy, usually eccentric but sometimes concentric

    • – Evidence of systolic or diastolic dysfunction may be present

DIAGNOSTIC PROCEDURES

  • Underwater weighing for determination of lean body mass

  • Skinfold thickness measures with calipers

  • Sleep study to detect sleep apnea

TREATMENT

CARDIOLOGY REFERRAL

  • Suspected cardiac disease

  • Difficult to control hypertension

HOSPITALIZATION CRITERIA

  • Heart failure

  • Respiratory failure

  • Planned procedure or surgery

MEDICATIONS

  • Weight loss through diet, exercise, and approved drugs

  • Assessment and treatment of comorbid conditions, such as hyperlipidemia, sleep apnea, and hypertension

  • Indicated treatment for heart failure or arrhythmias

SURGERY

  • Bariatric surgery in selected cases

MONITORING

  • ECG in hospital as appropriate

  • Daily weight

DIET AND ACTIVITY

  • Diet of 500–1000 kcal/day: 30% total fat, 7% saturated fat

  • Aerobic exercise for at least 30 minutes a day

ONGOING MANAGEMENT

HOSPITAL DISCHARGE CRITERIA

  • Resolution of problem

  • After successful surgery

FOLLOW-UP

...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MHE Privacy Center Close