Adult lipid and cardiovascular risk clinic. We see patients with high blood fats/lipids, review their results to try and establish the cause of the high lipids and work out if treatment is required and, if so, what options are available to you. Some lipid conditions run in families and it may be that your relatives e.g. your children need testing. One major role of the clinic is to make sure that we do not miss asymptomatic relatives in order to try and prevent future heart attacks and strokes.
Who do we see?
Dyslipidaemias (high or deranged blood lipids). People with complications of lipid problems e.g. pancreatitis and premature vascular disease People with side effects to lipid lowering medication People with poor control on current medications who require more treatment Specialist testing particularly looking into families with potential genetic lipid conditions or family history of premature vascular disease such as heart attacks and strokes. Limited screening of relatives directly, advice in regards to when family screening is required and what tests to perform. Also see general Metabolic patients particularly at Good hope hospital and sometimes at Heartlands
Outpatient department in Heartlands.
Outpatient department Good Hope
Contact information (if you want to speak to clinic organisers)?
Booking service for appointment alterations via contact information on the appointment letter
Contact Lipid clinic secretary for all other queries as follows:
What are the prereferral tests?
To help guide us with your management your GP will arrange for you to have some blood tests
What do you need to bring?
It is helpful to have a list of your medications if you can’t remember what they are.
What do I need to do?
Besides bringing your tablet list sometimes we ask people for fasting blood tests. Sometimes lipid tests can be done non-fasting. Please let us know if you cannot make an appointment as sometimes, even at late notice, an emergency patient can be asked to attend to fill your slot.
What do we do?
Diagnosis is based on your medical history, clinical examination and blood tests. Sometimes further investigations e.g. treadmill test may be indicated. Once a diagnosis is established then most treatment involves diet and lifestyle changes and some require medications, such as statins and fibrates, to reach treatment targets.
Who will I see?
The team at Heartlands consists of
Dr Alan Jones (Consultant Chemical Pathologist)
Dr Ummu Mayana (Honorary Consultant Chemical Pathologist)
Dr Sud Ramachandran (Consultant Chemical Pathologist) sees patients who have been referred to Good Hope at Good Hope Hospital. Heartlands and Good Hope are teaching hospitals therefore occasionally medical students and doctors in training may be present.
Other services available?
Some patients can be referred to the dietetics department for dietary advice. In rare cases we may ask cardiology or the diabetic team to become involved in your care. There is no paediatric or genetics service attached to the clinic. For children picked up in the clinic as having a genetic lipid disorder we refer them to the Birmingham Children’s Hospital to discuss further treatment.
In the last 5 years requests for tumour marker tests from Primary Care have more than doubled. This high use in Primary Care is worrying because the majority of tumour markers (eg. CEA, CA19-9) are neither specific nor sensitive enough for use in the diagnosis of malignancy. See this link for a summary of the main tumour markers, their uses and limitations.
The main use for tumour markers is in monitoring disease progression, treatment or recurrence of a histologically diagnosed cancer. A recent audit of Primary Care requests for tumour markers found that only 9% of CEA and 4% of CA19-9 were requested for these reasons; the rest being for non-specific symptoms.
In contrast to the above, CA125 and PSA do have use in diagnosis of their related cancers, however it should also be noted that these are still only a diagnostic aid and should be used with caution as both can be raised in a number of other benign conditions (see table). Please click the relevant links below of links to guidelines relating to their use in Primary Care.
Protection of Personal Information – Laboratory Medicine comply with the Trust Data Protection Policy and have procedures in place to allow the Directorate and it’s employees to comply with the Data Protection Act 1998 and associated best practice and guidance.
The Trust Laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital were awarded UKAS (United Kingdom Accreditation Service) accreditation to the internationally recognised ISO 15189 standard in May 2015. For a list of accredited tests and other information please visit the test database http://www.heftpathology.com/frontpage/test-database.html. Tests not appearing on this scope are either under consideration or in the process of accreditation and so currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.
For further information contact Louise Fallon, Quality Manager, 0121 424 1235