Cardiovascular conversation aid
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If an emergency may be happening, do not use this sheet
Contact your local emergency services now. Symptoms of a heart attack or stroke can be subtle and can differ from person to person. Concern is enough reason to seek urgent help, and no document can tell you it is safe to wait.
Family history as recorded
No family history was recorded. Unknown is information too, and it is worth saying out loud in the appointment.
Numbers as recorded
No laboratory values were recorded.
These values were entered or transcribed by the person named above and have not been verified against a laboratory report.
Questions to ask
- Does anything in this family history change what we should discuss or measure?
- Which of my numbers would you want to see, and how often?
- Is an inherited condition such as familial hypercholesterolemia worth considering in my case?
- Is a Lipoprotein(a) or Apolipoprotein B test appropriate for me?
- If something inherited were found, what would that mean for my relatives?
- What is the next thing you would want me to do, and when should I come back?
General education, the same for every reader
This section is identical on every copy of this sheet. It is background reading and is not about the person named above.
Why family history comes up in cardiovascular care
Clinicians often ask about cardiovascular events in close relatives because patterns across a family can change which questions and measurements are worth discussing. A family pattern is context for a conversation. It is not a diagnosis, and it does not predict what will happen to any individual.
Centers for Disease Control and Prevention, "Heart disease risk factors", retrieved 2026-07-14.
Familial hypercholesterolemia (FH)
Familial hypercholesterolemia is an inherited condition that raises cholesterol from early in life. The CDC describes it as frequently undiagnosed, and notes that it can lead to cardiovascular events earlier than would otherwise be expected. Because it is inherited, a diagnosis in one family member is information that matters to blood relatives as well.
Centers for Disease Control and Prevention, "About familial hypercholesterolemia", retrieved 2026-07-14.
Cascade testing: how families find inherited conditions
Cascade testing is the practice of offering testing to the blood relatives of someone found to have an inherited condition, working outward through the family. The CDC describes it as a way families identify relatives who share an inherited risk. Whether it applies to any particular family is a question for a qualified clinician.
Centers for Disease Control and Prevention, "Cascade testing", retrieved 2026-07-14.
Tests that a routine panel may not include
A standard lipid panel reports total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. Other measures, including Lipoprotein(a) and Apolipoprotein B, are ordered separately and are commonly absent from a routine annual visit. Whether any of them is appropriate for a given person is a clinical decision, not a general rule.
Centers for Disease Control and Prevention, "Heart disease risk factors", retrieved 2026-07-14. American Heart Association, "Primary prevention of cardiovascular disease: top things to know", retrieved 2026-07-14.
Imaging: what it can and cannot settle
Coronary artery calcium scoring and coronary CT angiography are imaging tests that answer specific clinical questions for selected people. Finding plaque is not the same as preventing a heart attack. The value of any test depends on appropriate selection, accurate interpretation, and a plan for acting on the result.
RadiologyInfo.org (RSNA and ACR), "Coronary computed tomography angiography (CCTA)", retrieved 2026-07-14. American Heart Association, "Primary prevention of cardiovascular disease: top things to know", retrieved 2026-07-14.
What can change
Blood pressure, cholesterol, blood sugar, tobacco exposure, physical activity, diet, sleep, and weight are among the factors clinicians work with. Inherited factors cannot be changed, but knowing about them earlier can change what care is offered and when.
Centers for Disease Control and Prevention, "Heart disease prevention", retrieved 2026-07-14. American Heart Association, "Life's Essential 8", retrieved 2026-07-14.
Unknown is information too
Many people cannot fill in a complete family history, and adoption, estrangement, early deaths, and incomplete records are all common. Recording what is unknown is genuinely useful, because unknown is clinically different from none.
Centers for Disease Control and Prevention, "About familial hypercholesterolemia", retrieved 2026-07-14.
How common familial hypercholesterolemia is
The CDC Office of Genomics reports studies estimating the prevalence of heterozygous familial hypercholesterolemia at about 1 in 250 people in the general population. The CDC has separately stated that of the more than 1 million people in the United States with FH, only about 30% know they have it.
Centers for Disease Control and Prevention, Office of Genomics, "How common is familial hypercholesterolemia?", retrieved 2026-07-25. Centers for Disease Control and Prevention, "About cascade testing for familial hypercholesterolemia (archived)", retrieved 2026-07-25.
Hypertrophic cardiomyopathy (HCM)
The American Heart Association describes hypertrophic cardiomyopathy as most often caused by abnormal genes that make the wall of the heart’s left ventricle thicker than normal, and as a common form of genetic heart disease. The AHA states that HCM has been regarded as the most common cause of sudden cardiac death in young people and competitive athletes in North America, while noting that it is rare. The NHLBI notes that HCM is commonly inherited and that first-degree relatives should be alerted and screened.
American Heart Association, "Hypertrophic cardiomyopathy", retrieved 2026-07-25. National Heart, Lung, and Blood Institute, "Cardiomyopathy: types", retrieved 2026-07-25.
Lipoprotein(a) and when guidelines say to measure it
The American College of Cardiology’s summary of the 2026 ACC/AHA multisociety guideline on the management of dyslipidemia states that Lipoprotein(a) should be measured at least once in adulthood, and notes that because lifestyle changes affect Lp(a) minimally, repeat testing is generally not needed. Whether and when it fits a particular person remains a clinical decision.
American College of Cardiology, "Summary of the 2026 ACC/AHA multisociety guideline on the management of dyslipidemia", retrieved 2026-07-25.
Apolipoprotein B (ApoB)
MedlinePlus describes apolipoprotein B100 as a protein that plays a role in moving cholesterol around the body, and describes the blood test as one used to help identify the cause or type of high cholesterol. It is ordered separately from a routine lipid panel. No threshold is given here, because the numbers that exist are either laboratory reference ranges or clinical goals tied to a person’s assessed risk category.
MedlinePlus, U.S. National Library of Medicine, "Apolipoprotein B100 blood test", retrieved 2026-07-25.
The early-event pattern in a family
The 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease lists a family history of premature atherosclerotic cardiovascular disease as a risk-enhancing factor, defining premature as before age 55 in males and before age 65 in females. Different clinical scoring systems use different age cutoffs for the same word, so the definition that applies depends on which instrument a clinician is using.
American College of Cardiology and American Heart Association, "2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: executive summary", retrieved 2026-07-25.
Unexplained drowning and inherited arrhythmia
GeneReviews notes that in long QT syndrome most sudden cardiac deaths occur during exercise such as swimming or during emotion, and that in an estimated 10% to 15% of people who die of long QT complications, death is the first sign of the disorder. An unexplained drowning or near-drowning in a relative is therefore worth mentioning to a clinician rather than being set aside as unrelated. The published case series behind this are small.
GeneReviews, University of Washington (NCBI), "Long QT syndrome overview", retrieved 2026-07-25.