Information for GPs

Tony Hillier Feb 2013“I think it is very important that general practitioners become aware of conditions causing sudden cardiac death in young people. Before my own daughter Laura collapsed and died in front of me in 2003, whilst working in my surgery, I knew little about the subject. She had undiagnosed ARVC.

It is through my subsequent contact with Cardiac Risk in the Young that my own awareness and knowledge has increased. Although these conditions are uncommon for individual GPs there are many of them and in practice, rare things occur commonly. They could affect any one of the families in a GP’s care at any time, and in my opinion, knowing where to obtain good support, information, and advice is crucial to effective general practice care. CRY is this source.” Dr Tony Hillier, GP.

It is important to refer family members to a specialist cardiologist after a diagnosis is made because many of the cardiac diseases causing sudden cardiac death are inherited.

Professor Mary Sheppard works closely with the fast-track screening service at the CRY Centre for Inherited Cardiac Conditions and Sports Cardiology at St. George’s Hospital, Tooting – a vital link offering screening to all first degree relatives together after a sudden death.

CRY can provide advice regarding referrals for expert screening for family members which aims to be within 4 weeks of receiving the referral.

On completion of the examination Professor Sheppard recommends that the family should be screened by a cardiologist with expertise in inherited cardiovascular conditions.

Professor Sheppard’s diagnosis provides vital information for the cardiologist which will direct the investigations of those individuals at risk.

The cardiologist will be provided with a copy of the pathology report, on request, from Professor Sheppard.

The process:

  • When Professor Sheppard examines the heart a small amount of tissue is taken from the heart which is embedded in wax to be preserved indefinitely. From these wax blocks thin sections are cut to look at under a microscope to look for hidden disease that cannot be seen by the naked eye.
  • These blocks and slides are, with family consent obtained by the coroner, preserved indefinitely. They are a valuable source for teaching and research.
  • If permission has been obtained by the coroner for the heart to be sent to Professor Sheppard it will be returned within 2 weeks in time for burial.
  • Taking of spleen may be required for genetic testing at the time of autopsy. This is only done if specific consent for research, teaching and genetics has been obtained.
  • If specific consent to retain tissue is not received for the purposes of research and teaching then the heart tissue blocks and slides will be returned to the referring hospital.