Cardiovascular risk in obesity: A silent epidemic

Abstract

Background Obesity is a major and multifactorial risk factor for cardiovascular disease, contributing to structural, metabolic, genetic, and electrophysiological alterations that predisposes to cardiovascular risk, with central adiposity and genetic predisposition further amplifying long-term risk. We report a 56-year-old obese male with a history of diabetes, hypertension, and prior myocardial infarction who presented with palpitations and chest pain. He was found to have atrial fibrillation with rapid ventricular response, successfully reverted to normal sinus rhythm by pharmacological cardioversion. Echocardiography demonstrated preserved left ventricular function with Grade 1 diastolic dysfunction. Coronary angiography revealed single-vessel disease involving the RCA and branch vessel involvement, which was managed successfully with percutaneous coronary intervention, including stenting of the mid to distal RCA and a drug-eluting balloon to the diagonal branch. Post-procedure management included antiplatelets, statins, hypoglycemic agents, and beta-blockers, supported by structured follow-up and patient education. This case underscores the critical importance of early risk stratification, individualized interventions, and integrated care to mitigate obesity-related cardiovascular morbidity and mortality, highlighting that personalized, multidisciplinary strategies are essential for improving long-term cardiometabolic health.