Heart Health Check (MBS: 699)
**Clinical History**
- Patient's father suffered a myocardial infarction at age 55, and her mother has well-controlled hypertension.
- Patient lives with her partner, works as an accountant, and reports moderate stress levels. She occasionally drinks alcohol but denies illicit drug use. Reports difficulty maintaining a regular exercise routine due to work commitments.
- Currently taking Atorvastatin 20mg daily for dyslipidaemia and Aspirin 100mg daily for primary prevention. Reports good compliance and understanding of medication purpose.
- Patient presented for a routine Heart Health Check. Reports no new cardiovascular symptoms. Discussed previous cholesterol results and blood pressure readings, which have been stable. Patient expressed interest in lifestyle modifications to further reduce her cardiovascular risk.
**Absolute CVD Risk Inputs (as per cvdcheck.org.au)**
Blood pressure: 130/85 mmHg
Total cholesterol: 4.8 mmol/L
HDL cholesterol: 1.2 mmol/L
LDL cholesterol: 2.8 mmol/L
Triglycerides: 1.5 mmol/L
Diabetes: no
Kidney disease: no
Smoking status: never smoked
Aboriginal/Torres Strait Islander or Pacific/Maori heritage: no
Family history of premature CVD (first-degree relative <60 yrs): yes
Other risk modifiers: reports moderate stress and occasional social isolation due to demanding work schedule.
**Lifestyle Goals**
**- Smoking**
"Heart Foundation goal: Quit smoking/avoid second-hand smoke"
My goal: Maintain your non-smoking status and continue to avoid second-hand smoke.
How and When: Continue current practice indefinitely.
**- Healthy Eating**
"Heart Foundation goal: Eat a heart healthy diet (vegetables, fruits, wholegrains, lean proteins, legumes, nuts, reduced-fat dairy, healthy fats, less salt)"
My goal: Increase vegetable intake to 5 servings daily and reduce processed food consumption.
How and When: Will start by planning meals for the week, aiming for 2-3 new vegetable-rich recipes in the next month. To be reviewed at next appointment on 1 November 2024.
**- Physical Activity**
"Heart Foundation goal: ≥30 minutes moderate activity most days"
My goal: Incorporate 30 minutes of brisk walking, 4-5 times per week.
How and When: Will schedule walks during lunch breaks or after work, starting next week. Will track progress using a fitness tracker.
**- Alcohol**
"Heart Foundation goal: ≤10 standard drinks/week, ≤4 on one day"
My goal: Limit alcohol consumption to 2 standard drinks per week.
How and When: Will track intake to ensure adherence, starting immediately.
**- Weight**
"Heart Foundation goal: Maintain healthy weight (waist <94 cm men, <80 cm women)"
My goal: Maintain current healthy weight and aim for a waist circumference below 80 cm.
How and When: Through continued healthy eating and increased physical activity, to be reassessed in 6 months.
**Other Problems**
- Patient expressed concerns about stress management; advised on mindfulness techniques and referred to online resources for stress reduction.
- Discussed importance of regular follow-up for CVD risk factor monitoring.