Case 3:“The Heart of the Matter” Unlike most other case studies , this one is not about individuals with defined symptoms requiring a diagnosis to be made but essentially a plunge into the murky waters of health screening and risk assessment. When considering the data, consider not the subjects’ current state of health but what might happen in the (near?) future. Mr Alan Grossman is a 59 year old self-employed businessman. He runs a ‘one- man’ consutaney and d@valoprient company which involves him traveling {oa Parts of the country to meet clients. Many of his evenings are spent doing paperwork ‘anet ACCOUNts So his limited ‘free time’ is usually spent in front of the TV. He now lives alone having been twice married and twice divorced. The two children form his first marriage now live abroad. "The daughter Tom Ms second marriage has recently finished a BA in Fashion and Design. Because she was awarded a First class degree, she feels that to take any full-time job which pays less than £40,000 pa would be demeaning for such a ‘high flyer’ so she relies on dad (and mum) to fund her flamboyant ‘artistic’ life style. Mr Archie McLeen is approaching his 61* birthday. Originally from Edinburgh, he recently retited (after 32 years spent as an administrator in a goverment department in Whitehall), to a small vilage near the Sussex coast. Unfortunately, Mrs McLeen died just under a year ago so Archie now spends most of his time with his faithful spaniel (Charlie); they walk several miles each day through the local countryside. His Civil Service Pension is more than adequate to fund his modest lifestyle and with no children or other relatives to support or mortgage to pay he enjoys a quiet, comfortable existence. Page 1 of 3‘Clinical Examination Both gentlemen attended their respective GP surgeries for a routine check-up Mr Grossman's doctor noticed that her patient was; () slightly overweight but not clinically obese: Calcul = 28kgim? ref. <25), and (id slightly hypertensive ‘On questioning, Mr Grossman admits to being a smoker and that he consumes a bottle of Scotch whisky in @ month in addition to ‘social’ drinking associated with his work commitments. His diet consists of a lot of ‘convenience’ foods and he often eats in motonway service areas when travelling torfrom business meetings. Mr Grossman comments that he often feels ‘tied and lethargic’ but is otherwise well, His family ‘medical history is uninformative, ~~ Mr MoLeen is well built and seemingly fit for his age. He claims to eat sensibly at home during the week but will usually stop off at his local for Sunday lunch after a brisk waik with Chariie (the dog). He drinks (mostly red) wine in moderation and has never been a smoker. However, the GP is a litle concerned that; () Mr MeLeen’s blood pressures high (150/10), Gi) McLeen senior died suddenly from a massive acute myocardial infarction at the ‘age of 65 yrs, (i) the patient has some small yellow patches around the eyelids. Blood samples were taken from both subjects and sent for analysis. Page 2 of 3‘The GPs drew blood samples and these were sent for analysis. Results tests. | Test Mr.G Mr. Mel. tera wega) (as) ot (eraseesxto2) Baxt0" 48x10 este 78x 10° 6.4 x10? fe 13-148 molt) $e 2 (eta e7 moll) a ae eee eae 119 108 (er oat) ere Se 3) v2 fee eboney 2 a (y ee 42 at (etargeta aor 58) [ae eee 1.36 (2.5 Calum Bie as Rikaline 88 a a0 ay =| ee Page 3 of 3