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Metabolic Syndrome Clinical Presentation

  • Author: Stanley S Wang, MD, JD, MPH; Chief Editor: Yasmine Subhi Ali, MD, FACC, FACP, MSCI  more...
 
Updated: Dec 27, 2015
 

History

As with other diseases, careful history taking is important in metabolic syndrome. Even though the condition is diagnosed based on physical and laboratory features, it may be suspected if symptoms of any of the component disorders are present, such as the increased hunger, thirst, or urination that may accompany hyperglycemia.

Patients reporting a history of hypertension, dyslipidemia, or hyperglycemia warrant screening for metabolic syndrome. Symptoms suggesting the rise of cardiovascular and other complications, such as chest pain or shortness of breath, must be investigated carefully. As lifestyle changes can ameliorate the condition, attention should be paid to the patient’s dietary habits and exercise routines so that areas for improvement can be identified.

The patient’s social history is important for identifying additional risks, such as tobacco use, which may exacerbate the increased cardiovascular complications associated with metabolic syndrome.

A family history should be obtained because genetics may play an important role in metabolic syndrome. This feature of the disease is under active investigation; however, no gene or group of genes has yet been implicated consistently, suggesting that environment exerts substantial influence.[75]

Finally, a thorough review of systems may help to identify related problems, such as menstrual irregularities that can be seen in polycystic ovarian syndrome.

Next

Physical Examination

The physical examination is crucial in patients with metabolic syndrome, as the findings of elevated blood pressure and abdominal obesity are 2 of the 5 diagnostic criteria. Measurement and documentation of waist circumference are important routines when screening for metabolic syndrome.

The examination may also reveal findings reflective of the other criteria. For example, patients with insulin resistance and hyperglycemia or with diabetes mellitus may have acanthosis nigricans, hirsutism, peripheral neuropathy, and retinopathy. Patients with severe dyslipidemia may have xanthomas or xanthelasmas. The presence of arterial bruits may portend a higher risk of cardiovascular complications.

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Contributor Information and Disclosures
Author

Stanley S Wang, MD, JD, MPH Clinical Cardiologist, Austin Heart South; Director of Legislative Affairs, Austin Heart; Director, Sleep Disorders Center at Heart Hospital of Austin; Assistant Professor of Medicine (Adjunct), University of North Carolina School of Medicine

Stanley S Wang, MD, JD, MPH is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American Heart Association, American Society of Echocardiography, Texas Medical Association, American Academy of Sleep Medicine, American Stroke Association, American Society of Nuclear Cardiology

Disclosure: Nothing to disclose.

Chief Editor

Yasmine Subhi Ali, MD, FACC, FACP, MSCI President, Nashville Preventive Cardiology, PLLC; Assistant Clinical Professor of Medicine, Vanderbilt University School of Medicine

Yasmine Subhi Ali, MD, FACC, FACP, MSCI is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, Tennessee Medical Association, National Lipid Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: MCG Health, LLC; MedStudy<br/>Serve(d) as a speaker or a member of a speakers bureau for: MedStudy<br/>Received honoraria from MedStudy for independent contractor; Received salary from MCG Health, LLC for employment; Received fees from About.com for independent contractor.

Acknowledgements

Justin D Pearlman, MD, ME, PhD, FACC, MA Chief, Division of Cardiology, Director of Cardiology Consultative Service, Director of Cardiology Clinic Service, Director of Cardiology Non-Invasive Laboratory, Director of Cardiology Quality Program KMC, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School

Justin D Pearlman, MD, ME, PhD, FACC, MA is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Federation for Medical Research, International Society for Magnetic Resonance in Medicine, and Radiological Society of North America

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

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