Clinical and Subclinical Atherosclerotic Disease in Adolescents With Familial Hypercholesterolemia

Figures

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  Figure 1. Cutaneous Manifestations of FH in Case 1 (A, C, and D) Tuberoeruptive xanthomas. (B) Xanthelasma and arcus cornealis. FH = familial hypercholesterolemia.

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  Figure 2. Electrocardiogram of Case 1 Twelve-lead electrocardiogram showing significant ST-segment elevation in lead aVR and marked ST-segment depression in leads II, III, aVF, and V1 to V6.

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  Figure 3. Carotid Intima-Media Thickness of Case 1 (A) Echocardiography showing an ejection fraction of 42%. (B) Ultrasound Doppler showing increased CIMT in the right common carotid artery. (C) Ultrasound Doppler showing calcified plaque of 5 × 3 mm at the bulb of the left common carotid artery. CIMT = carotid intima-media thickness.

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  Figure 4. Coronary Angiography and Percutaneous Coronary Intervention of Case 1 (A) Right anterior oblique cranial view showing mid to distal LAD stenosis (80%-90%) with the tightest portion across the D2. (B) Wire in the LAD and balloon in the mid LAD across the D2. (C) Results after deployment of drug-coated balloon. D2 = second diagonal branch; LAD = left anterior descending artery.

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  Figure 5. Coronary Angiography and Percutaneous Coronary Intervention of Case 2 (A) Coronary angiography left anterior oblique caudal view showing ostial LMCA 99%, distal LMCA 80%, and (B) mid LAD 70% lesions. (C) DES implantation in the proximal LMCA. (D) DES implantation from the LMCA to LAD. (E and F) postprocedural final result. DES = drug-eluting stent; LAD = left anterior descending artery; LMCA = left main coronary artery.

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  Figure 6. Cutaneous Manifestations of FH in Case 3 (A to C) Tuberoeruptive xanthomas. FH = familial hypercholesterolemia.

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  Central Illustration. Clinical and Subclinical Atherosclerotic Disease in Adolescents With FH CIMT = carotid intima-media thickness; DEB (DCB) = drug-coated balloon; FH = familial hypercholesterolemia; PLEX = plasma exchange.