This may be completely off base but I found it interesting due to your high lipids, etc. Which, I know, can be due to drugs. I simply found it interesting that acetylcholine was involved in this process. Since you are going to medical school, why not start here!


http://lib.bioinfo.pl/auid:418508

Circulating and tissue endothelin immunoreactivity in hypercholesterolemic pigs.
A Lerman, M W Webster, J H Chesebro, W D Edwards, C M Wei, V Fuster, J C Burnett Jr
Department of Internal Medicine, W.D.E., C.M.W., J.C.B.), Division of Cardiovascular Disease Mayo Clinic and Foundation, Rochester, Minn 55905.
BACKGROUND. Hypercholesterolemia is characterized by a coronary vasoconstrictive response to the endothelium-dependent vasodilator acetylcholine. This abnormality may be due to reduced synthesis of endothelium-derived relaxing factor and/or enhanced synthesis and release of an endothelium-derived contracting factor. Endothelin is an endothelium-derived vasoconstrictor and mitogenic peptide that is present in normal plasma, and its circulating concentrations are elevated in disease states that are characterized by abnormal endothelium-dependent relaxation to acetylcholine. The current studies were designed to test the hypotheses that experimental hypercholesterolemia results in elevation of plasma and tissue endothelin immunoreactivity and that the abnormal acetylcholine-evoked coronary vasoconstriction in the hypercholesterolemic animals is associated with further elevation of plasma endothelin. METHODS AND RESULTS. Plasma concentrations and molecular forms of endothelin immunoreactivity were determined following 2% cholesterol diet for 4 months in pigs and during intracoronary acetylcholine administration. Second, we assessed the presence of endothelin in the coronary vascular wall by using immunohistochemistry. Hypercholesterolemia elevated plasma endothelin concentration and enhanced coronary artery tissue endothelin immunoreactivity. The endothelium-dependent vasodilator acetylcholine further increases plasma endothelin in hypercholesterolemia in association with coronary vasoconstriction. The predominant molecular form of endothelin in hypercholesterolemia is the biological active endothelin-1. CONCLUSIONS. This study suggests a role for endothelin as an early participant and a marker for the endothelial dysfunction in hypercholesterolemia as well as a participant in the atherogenic process.

http://circ.ahajournals.org/cgi/cont...ll/107/22/2805

You may "only" be having a drug reaction or interaction issue but the endothelial dysfunction is an interesting thought.