High cholesterol physical examination

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

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): xanthelasma palpabrum (yellowish patches around the eyelids) and arcus senilis (white discoloration of the peripheral cornea).

• 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