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Irma Bagdoniene: Multidisciplinary Management of High-Risk Familial Hypercholesterolaemia and CAD
Irma Bagdoniene/LinkedIn
Oct 5, 2026, 15:31

Irma Bagdoniene: Multidisciplinary Management of High-Risk Familial Hypercholesterolaemia and CAD

Irma Bagdoniene, Medical Doctor, shared a post on LinkedIn:

“Story from the Lipid Clinic Part 2

Remember the patient with vague chest symptoms, an untreated LDL-C of 234 mg/dL, elevated Lp(a), and a coronary CT showing extensive coronary atherosclerosis?

Her story continued. Because of the pathological CT findings and her exertional symptoms, she underwent invasive coronary angiography.

  • The proximal LAD showed an 80 percent stenosis. Physiological assessment confirmed its relevance: iFR 0.85–0.86.
  • The RCA showed significant disease as well, including a 90% distal stenosis. FFR was 0.78, confirming functionally relevant ischemia.

Both vessels were successfully treated with PCI and drug-eluting stents. What started with years of high LDL cholesterol and rather unspecific symptoms had become established, intervention-requiring two-vessel coronary artery disease.

But for me, this case is about much more than finding stenoses and placing stents. It shows what can happen when the different pieces of cardiovascular medicine come together.

Prevention recognised the risk: high lifetime LDL exposure, family history and symptoms that could easily have been dismissed as nonspecific.

Lipidology raised the suspicion of familial hypercholesterolaemia and identified markedly elevated Lp(a).

Cardiac imaging made the burden of coronary atherosclerosis visible.

Coronary physiology with iFR and FFR showed which lesions were functionally significant. Interventional cardiology successfully treated the relevant coronary lesions.

And now the story returns to secondary prevention: intensive LDL lowering, antiplatelet therapy and management of every modifiable cardiovascular risk factor. Her LDL-C target is now 40 mg/dL , and her lipid-lowering therapy will be intensified accordingly.

Teamwork! It takes a village…

Prevention. Lipidology. Cardiac imaging. Coronary physiology. Interventional cardiology. Nursing. Follow-up. And, most importantly, the patient herself.

Did we prevent a future myocardial infarction? We will never know. Now begins the long-term task of keeping her cardiovascular risk as low as possible.

To be continued…

Part 1

P.S. what raised my suspicion even further was this small carotid plaque – almost as if the vessels were trying to tell us something before the coronary CT did.

And a very special thanks to my favourite team player in the cath lab: Dr. med. Mohammad Al Mawed.”

Irma Bagdoniene: Multidisciplinary Management of High-Risk Familial Hypercholesterolaemia and CAD

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Cardiac imaging cardiovascular risk Coronary physiology Familial hypercholesterolaemia Health Hematology Hemostasis Hemostasis News Hemostasis Today interventional cardiology Irma Bagdoniene LAD LDL Lipidology Medicine Myocardial infarction
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