system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 35-year-old man comes to the physician because of several episodes of crushing substernal chest pain on exertion over the past 6 weeks. The pain occurs when he goes for his morning run and disappears if he slows down to a walk. The patient is concerned because two of his uncles died of myocardial infarction in their early 50s. Physical examination shows yellow plaques on both the palms. An ECG shows no abnormalities. Serum lipid studies show:
Total cholesterol 650 mg/dL
HDL cholesterol 30 mg/dL
VLDL cholesterol 185 mg/dL
Triglycerides 800 mg/dL
Chylomicron remnants elevated
Which of the following is the most likely cause of this patient's symptoms?"
assistant
Defective apolipoprotein E
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