What guidelines should I follow for referring patients with suspected inherited cardiac conditions to a specialist?

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 ¹. A low threshold for referral is recommended ¹. An urgent referral means as soon as possible, with a maximum of 14 days ¹.
• 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 ¹.
• 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) ¹. 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 ¹.
• 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 ¹. 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 ¹.