© 2003 Fellowship of Postgraduate Medicine
IMAGES IN MEDICINE
Palmar striated xanthomas
Department of Medicine and Cardiology, Frenchay Hospital, Frenchay Park Road, Bristol BS16 1LE, UK; darbhamulla@aol.com
| The first 150 words of the full text of this article appear below. |
A 52 year old woman presented to the emergency department with two hours of central chest pain. She had no past medical history of ischaemic heart disease, diabetes, or hypertension. She had a family history of ischaemic heart disease; her brother had a myocardial infarction when 50 years old. She was taking no medication.
She smoked 20 cigarettes per day and had a 38 pack year history. On examination she was found to have palmar striated xanthomas (fig 1
) and she was found to have hypothyroid facies on general examination. Her systemic examination was normal. Electrocardiography revealed T-wave inversion in lateral leads. Serial troponin I measurements were <0.3 mmol/l (Bayer Centaur: normal <0.3 mmol/l). Her serum was lipaemic (fig 2). Lipid profile revealed a serum cholesterol of 14.2 mmol/l and triglyceride of 9.3 mmol/l. Thyroid function tests were consistent with hypothyroid state with a thyroid stimulating hormone concentration
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