Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
For patients with suspected inherited cardiac conditions, specifically Familial Hypercholesterolaemia (FH), the following referral guidelines should be followed:
- Urgent Referral to a Cardiology Specialist: Healthcare professionals should offer people with FH an urgent referral to a specialist with expertise in cardiology for evaluation if they have symptoms or signs of possible coronary heart disease which are not immediately life-threatening NICE CG71. A low threshold for referral is recommended NICE CG71. An urgent referral means as soon as possible, with a maximum of 14 days NICE CG71.
- If a person with FH presents with symptoms or signs of possible coronary heart disease which are immediately life-threatening (for example, acute coronary syndrome), they should be referred to hospital as an emergency, in line with advice for the general population NICE CG71.
- Consider Referral for Evaluation of Coronary Heart Disease: Healthcare professionals should consider offering people with FH a referral for evaluation of coronary heart disease if they have a family history of coronary heart disease in early adulthood, or two or more other cardiovascular risk factors (for example, male sex, smoking, hypertension, or diabetes) NICE CG71. Premature coronary heart disease refers to a coronary event that has occurred before 60 years of age in an index individual or first-degree relative NICE CG71.
- Specific Populations: Upon diagnosis, all adults and children and young people with homozygous FH should be offered a referral for an evaluation of coronary heart disease NICE CG71. In asymptomatic children and young people with heterozygous FH, evaluation of coronary heart disease is unlikely to detect clinically significant disease, and referral should not be routinely offered NICE CG71.