Lipid Blood Test

Name

Institution name

Date

Lipid Blood Test

Test description

The lipid blood test was conducted mainly for the purpose of checking any risks for coronary heart disease. A complete cholesterol test is a blood test used in measuring the amount of cholesterol and triglycerides in the blood. This test assists in determining the risks of the buildup of plaques in the arteries that can cause narrowing o blockage of the arteries throughout the body (Hickman, 2007). This test is therefore an important tool that can help prevent significant risks for coronary artery disease. At this point, high cholesterol causes a great level of risk.

High cholesterol normally has no signs and symptoms and therefore cannot be identified without a test. A complete lipid test is conducted to estimate the cholesterol density and to determine whether or not one is at risk of having heart attacks or develop other heart diseases and diseases of the blood vessel.

The test profile would include:

Total cholesterol; the total density of cholesterol present in the blood
High-Density Lipoprotein cholesterol (HDL-C); also known as good cholesterol. Carries away LDL cholesterol hence enabling the free flow of blood.
Low-Density Lipoprotein cholesterol (LDL-C); also known as bad cholesterol. Too much LDL-C in the blood can cause the buildup of fatty deposits in the arteries which can reduce the flow of blood. The plaques may rupture causing heart attacks or sometimes strokes.
Very Low-Density Lipoprotein cholesterol (VLDL-C)
LDL/ HDL ratio
Triglycerides are a type of fat found in the blood. The blood converts calories it does not need into triglycerides which are then stored in fat cells. High triglyceride levels are caused by eating too many sweets and drinking a lot of alcohol, being overweight, smoking, and having diabetes with elevated blood sugar levels.

This is a fasting lipid profile test conducted to identify the density of lipoprotein cholesterol. The test is conducted following several symptoms that point towards dyslipidemia. The symptoms include:

Squeezing sensation of the heart
Sweating
Pain on the left hand
Headache
Nausea and vomiting
Difficulty in breathing

Before the collection of the blood specimen, the doctor requests a twelve to fourteen-hour fasting where one is only allowed to take water. Fasting is important in eliminating other substances from the blood which may interfere with the test’s accuracy.

Sample types required

The antemortem blood will be collected through venepuncture which will be done on the antecubital region of the arm. The blood will be drawn from the vein using a syringe or evacuated container. After the collection of blood, an antiseptic wipe would be used to wipe and clean the collection site (Robertson, 2008). A non-alcoholic antiseptic is preferred in this case so as not to contaminate or interfere with the alcohol analysis.

Sampling procedure

The test is mostly done in the morning since one has to fast for the test to be most accurate. However, the timing of the test is not specifically in the morning and the test can be done at any time of the day. Blood is drawn from the vein and usually from the arm.

Before inserting the needle, the puncture site is wiped with an antiseptic to clean the area.
An elastic band is wrapped around the upper part of the arm to make the vein in the arm fill up with blood.
The needle is inserted into the vein and blood drawn into the vial or a syringe
After inserting the needle, the elastic band is removed to restore the circulation of blood through the vein as blood keeps flowing into the vial.
Once blood is collected, the needle is removed and the puncture site is covered with a bandage to protect the punctured site from infection.

The lipid test takes only a couple of minutes and the procedure is relatively painless. There are no precautions that need to be taken after the test. One should be able to get back to their normal life activities after the test. Additionally, in any case, the patient who was fasting before the test can start eating immediately after the cholesterol test.

Storage

Blood is mostly stored in evacuated blood tubes which are typically glass. However, plastic tubes can also be used in the storage of blood. The blood is mostly stored for a short period of time because clinical tests do not take long. Before use, the sample should be stored at a refrigerated temperature of 4⁰ C for a short period (Robertson, 2008). Since the test is conducted almost immediately, there is no need for preservation of the blood sample.

All samples are well labeled with identification case numbers, the name of the donors, date, and the time of sample collection. This is to prevent any confusion during the test. The identification of the samples and the results are done by considering the identification number and the name of the donor. Tape bearing the collector’s credentials and date of collection is used.

Internal and External Quality Control

Internal and external quality control ensures quality in the procedures and the results of the tests conducted. Quality and competence are important in ensuring proper and accurate laboratory results. Internal quality control would involve the use of technological machines, proper storage equipment, and sampling technology (Gonnella, 1983). Using appropriate equipment during the test would ensure quality and accuracy. Additionally, the results should be provided in a short duration. It is not only the quality that matters but also the availability of results when required. The tests should be conducted and results produced immediately.

Internal control is observed at all levels of daily laboratory practices. For instance, internal control is applicable during specimen collection, processing, instrumentation, maintenance, and reporting of the test results. Initial calibration and routine maintenance are carried out periodically to ensure the efficiency and reliability of the tests. Several practices and activities are done to ensure proper internal control:

Ensure proper collection and storage of specimens which involves storing them under refrigeration temperature.
Ensuring proper functionality of all machines in the laboratory and double-checking results to ensure accuracy.
Proper instrumentation should be considered.
Routine maintenance of instruments which incorporates repair of machines and cleaning of the instruments to avoid contamination of the specimen.

External control is the retrospective analysis of the internal quality control results conducted by an external organization. The samples of the result are provided by the laboratory and the results are analyzed and sent back to the participants. The performance of participant agencies is compared with those of other agencies in the worldwide scheme (Gonnella, 1983). The external quality assessment scheme is aimed at determining the performance of the participating laboratories and comparing the results as a way of coming up with a success range. The results of the external control assessment contain deviations of estimations from other laboratories from each chemistry and the bias of the laboratory for over and under-reporting in a particular parameter.

Biological Variation and Delta Checks

Total cholesterol (mg/dl) Comment

< 200 Desirable

200 – 239 Borderline high

>240 High

LDL Cholesterol (mg/dl)

< 100 Optimal

100 – 129 near optimal

130 – 159 Borderline high

160 – 189 High

>190 Very high

HDL Cholesterol (mg/dl)

< 40 Low

>60 High

Triglycerides (mg/dl)

< 150 Desirable

150 – 199 Borderline high

200 – 499 High

>500 Very high

Reference Range

Individuals with total cholesterol concentrations above the limit are incorrectly classified as being at increased risk of disease especially when the increase in total cholesterol results entirely from an increase in the High-Density Lipoprotein cholesterol, which is considered as protective. The data is reliable for the categorizing of risks associated with the parameters. The results of the measurements and the calculations are expressed in mmol/L. The result is reported only to the first decimal place.

HDL-C >1.0 mmol/L

LDL-C <2.0mmol/L (for patients at high risk)

<2.5mmol/L (for patients at lower risk)

TG <1.5 mmol/L

Cholesterol concentration for heart attack patients

There are high risks of cardiovascular events with a Low-Density Lipoprotein concentration of above 130 – 159 mg/dl. With the acceptable LDL concentration levels at less than 100 – 130 mg/dl, the patient is more likely to have another factor affecting his health. For example, being overweight with an abnormal level of Triglycerides ranging at >350 mg/dl, the cause of the heart attack can be determined (University of California – Los Angeles, 2009). Based on the cholesterol concentration test, the patient can be said to have abnormal cholesterol concentration. The patient is therefore more likely to develop fatal cardiovascular events. The result shows that the patient is at a high risk of having blocked veins as a result of excess fat in the blood. Additionally, the patient’s Low-Density Lipoprotein concentration sets poor health conditions which may cause cardiovascular complications.

A large number of patients hospitalized for heart attack are also associated with low levels of High-Density Lipoprotein concentration. To solve the situation, the Low-Density lipoprotein concentration for those at risk of cardiovascular events should be lowered to meet the desired concentration. The High-Density lipoprotein concentration on the other hand should be raised using proper treatment schemes to meet the desired concentration. In addition to that, patients and those at risk of cardiovascular events should ensure proper health and living conditions. For instance, a lifestyle change can reduce the chances of one having a heart attack. Regular exercises, avoiding smoking and excess alcohol, and ensuring a proper and healthy diet are advisable. People at risk of cardiovascular events should also maintain regular medical checkups and perform lipid blood tests after every five years.