Page 32 - Clinical Pearls in Cardiology

20 Clinical Pearls in Cardiology

in between the arcus and the sclera. The usual ‘arcus
senilis’ seen in elderly, is not necessarily associated with
hypercholesterolemia or coronary disease. It usually
begins superiorly and it extends to the rim or limbus of
the iris (Fig. 8).

Fig. 7: Arcus in hypercholesterolemia

Fig. 8: Arcus senilis

Another important clinical marker of hyper-
cholesterolemia is xanthelasma. Xanthelasmas are flat,
yellowish, intracutaneous, cholesterol-filled plaques.
They are located on or around the eyelids, usually near
the inner canthus (Fig. 9).