High cholesterol physical examination

Cholesterol Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Elevated cholesterol does not lead to specific symptoms unless it has been longstanding. Some types of hypercholesterolemia lead to specific physical findings: xanthoma (thickening of tendons due to accumulation of cholesterol), xanthelasma palpabrum (yellowish patches around the eyelids) and arcus senilis (white discoloration of the peripheral cornea).

Physical Examination

Elevated cholesterol does not lead to specific physical examination signs unless it has been longstanding. Some types of hypercholesterolemia lead to specific physical findings:

• Head, eyes, ears, nose throat (HEENT):
  • Arcus senilis (white discoloration of the peripheral cornea)
  • xanthelasma palpabrum (yellowish patches around the eyelids). Shown below is an image depicting xanthelasma.

• Heart and Lungs: Congestive heart failure and rales due to ischemia or myocardial infarction (heart attack)

• Extremities:

• Xanthoma (thickening of tendons due to accumulation of cholesterol)
• Reduced femoral, posterior tibial, and dorsalis pedis pulses and femoral bruit due to peripheral artery disease (PAD)

• Neurologic exam: Signs of either transient ischemic attacks (TIAs) or cerebrovascular accidents/Strokes