Cardiovascular Health Case Study

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Cardiovascular Health:
Florence
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Florence is a 58-year-old married woman of
Caucasian descent. She has been healthy all of
her adult life, until recently. Two months ago
she had her gallbladder removed after an
acute gallstone attack; this was her first
surgery. This week, her physician told her that
she has high cholesterol and needs to try to
change her health behaviors. After six weeks,
her physician will re-test her cholesterol and
decide whether to prescribe lipid-lowering
medication.

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Patient Statement
I have been healthy all my life except for this gallbladder
surgery, and then all of a sudden I have high cholesterol? I
just don’t understand it. I exercise a lot, and I don’t eat junk
food all the time, so there’s no reason I should have any
health problems. I have too much to do at home to be
worrying about going on some extreme diet or going to an
expensive gym for 3 hours a day.

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Psychosocial Profile
Florence has a BA and
previously worked part-time
as a librarian, but she is
currently unemployed. She is
very disappointed by this
second health issue in such a
short amount of time. She is
30 lbs lighter than she was
last year, when her
cholesterol was normal, so
she is confused and
frustrated by the fact that her
health appears to be getting
worse. Notably, both of her
parents passed away from
vascular diseases, and
Florence is experiencing
anxiety about how this family
history will affect her. She
feels pressure to get better
quickly, because she is the
primary caregiver for her
adult, son who has
schizophrenia, and her
husband, who has limited
mobility and frequent
complications from diabetes.
Apart from these two
relatives, Florence does not
have any family in the area.
She regularly attends church
and is a member of a local
quilting guild. Florence had to
quit her job to care for her
husband and son, and her
family is currently supported
by a combination of disability
income, a small pension, and
Social Security. She is
concerned about the
additional cost of these new
health issues. Florence has
never been evaluated by a
mental health professional,
but she occasionally attends a
support group for parents of
adult children with
schizophrenia. When things
go wrong, Florence tries to
tackle the problem, but
occasionally gets discouraged
by how challenging the
situation is.

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Exercise Profile
Florence attends a
resistance training class
three times a week at a
local community center,
and she occasionally takes
a walk in her
neighborhood.

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Dietary Profile
Florence’s dietary profile was evaluated via self-report
during her office visit. Her food recall shows a limited intake
of fruits and vegetables, approximately 15 grams of fiber
daily, limited dairy intake, and frequent consumption of
foods high in saturated fat.

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Medical Profile
Florence is 5’8” and weighs 203 lbs (BMI = 31). Her waist
circumference is 38.5”. Her most recent labs were: total
cholesterol = 252 mg/dL, LDL cholesterol = 166 mg/dL, HDL
cholesterol = 40 mg/dL, triglycerides = 133 mg/dL.