July 26, 2021

How should a GP help manage high cholesterol or diagnose a heart attack?

Heart attacks and high cholesterol often go hand in hand. So, what should a GP be doing to ensure that these issues are treated promptly and effectively?

Mismanagement of statin treatment – what to look out for

We have seen many cases where GPs have failed to prescribe and/or manage treatment to lower cholesterol.

Statin treatment aims at reducing your risk of cardiovascular disease and, according to the NICE Guidelines, your GP should take a blood sample to check how well your kidneys and liver are working. Your liver function should also be measured within three months of starting treatment and then a year later.

Checking that the statin is working is also important as if your cholesterol level has not decreased enough, your GP should work with you to address this, whether it be through lifestyle change or changing your medication to a higher dose.

Furthermore, you should be offered regular reviews and advised whether certain medication you are taking is likely to interfere with the statin.

However sometimes, unfortunately, despite intervention from medical professionals heart attacks can still occur. So what should they do when they spot the signs of a cardiac event?

What should a GP do if they suspect a heart attack?

Delayed diagnosis of a heart attack can occur when you have suffered from symptoms suggestive of a heart attack but your GP has failed to act promptly by either calling an ambulance or telling you to attend hospital urgently. You may have been feeling short of breath, feeling weak and/or lightheaded or have been suffering chest pain which was radiating to your jaw, neck, arms or back.

It is important that your GP takes an initial assessment and determines whether or not the chest pain is cardiac related by taking a full medical history, particularly relating to your heart.

According to the NICE Guidelines, your GP should refer you to hospital as an emergency if an acute coronary syndrome (ACS) is suspected. ACS is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart such as a heart attack. Management of ACS should start as soon as it is suspected, but should not delay transfer to hospital. According to the guidelines, you should be offered pain relief as soon as possible as well as a single dose of 300mg aspirin unless there is clear evidence you are allergic to it.

If ACS is suspected but there is no requirement for an emergency referral, you should be referred to hospital for an urgent same-day assessment, according to the NICE Guidelines. Reasons why there may be no need for an emergency referral is if you had chest pain in the past 12 hours but are now pain free and/or the last episode of pain was 12 to 72 hours ago.

If your GP has failed to do some of the above and delayed diagnosis and/or treatment of a heart attack, or mis-managed your statin treatment, then you may have a claim for clinical negligence.

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