Date:
Patient:
MRN:
Clinician: (Cardiologist, Lipid Specialist, Primary Care Physician)
Reason for Visit:
Follow-up for FH
Lipid panel results and treatment plan
Discussion of lifestyle modifications
Consideration of genetic testing for family members
History of Present Illness:
Briefly describe the patient’s current status:
Age at diagnosis of FH (genetic testing or family history)
Current medications for cholesterol management
Presence of any cardiovascular (CV) symptoms (chest pain, shortness of breath)
FH (family history) of high cholesterol or premature coronary artery disease (CAD) in first-degree relatives
Past Medical History:
Include any relevant past medical conditions, such as:
Existing coronary artery disease (CAD)
Peripheral artery disease (PAD)
Stroke
History of tendinopathy (muscle pain) associated with statin use
Family History:
Document details of high cholesterol or premature CAD in first-degree relatives (age of onset, treatment history).
Social History:
Diet (high saturated fat, cholesterol intake)
Physical activity level
Smoking history (current and past) – significant risk factor for atherosclerosis
Labs:
Lipid panel:
Mention LDL-C, HDL-C, total cholesterol, and triglyceride levels.
Discuss how these values compare to FH treatment goals.
Consider mentioning other labs as relevant, such as:
Lipoprotein(a) – may be elevated in some FH patients
Imaging:
Imaging studies are not routinely performed for FH diagnosis, but may be obtained to assess for existing cardiovascular disease (e.g., coronary angiography).
Genetics:
Document the specific FH mutation identified (if known).
Mention any recent genetic counseling updates or discussions about testing cascade for family members.
Assessment:
Confirm the diagnosis of FH based on genetic testing or family history and elevated LDL-C levels.
Assess the patient’s current cardiovascular risk based on lipid profile, presence of existing atherosclerotic disease, and other risk factors.
Plan:
Outline a comprehensive treatment plan to lower LDL-C and reduce CV risk:
Lifestyle modifications:
Emphasize a heart-healthy diet low in saturated fat and cholesterol.
Encourage regular physical activity.
Smoking cessation counseling (if applicable).
LDL-C lowering medications:
Statins are the cornerstone of therapy for most FH patients.
Consider other lipid-lowering medications (ezetimibe, PCSK9 inhibitors) if statin therapy is not enough to reach LDL-C goals or if there are side effects.
Genetic counseling: Discuss the importance of identifying other family members who may have FH.
Prognosis:
Briefly discuss the prognosis. With early diagnosis, aggressive LDL-C lowering therapy, and lifestyle modifications, FH patients can significantly reduce their risk of premature cardiovascular disease.
Education:
Document any education provided to the patient regarding:
The nature of FH and its implications for cardiovascular health
Importance of dietary changes and physical activity
Benefits and potential side effects of cholesterol-lowering medications
The rationale for genetic testing in family members
Notes:
Include any additional relevant information not covered above, such as the patient’s adherence to the treatment plan and any emotional concerns they may have.
Consider mentioning the importance of lifelong monitoring and potential need to adjust medications or lifestyle recommendations over time.
Disclaimer: This is a template and should be adapted to the specific needs of each patient. It is important to consult with a healthcare professional for diagnosis and treatment recommendations.