Signs and symptoms of heterozygous FH in adults include the following:
Long-standing history of severe hypercholesterolemia dating back to childhood
If no previous acute coronary event, symptoms consistent with ischemic heart disease, especially in the presence of other cardiovascular risk factors (especially smoking)
Past or present symptoms of recurrent Achilles tendonitis or arthritic complaints
If heterozygous FH is left untreated, tendon xanthomas (Achilles tendons, metacarpophalangeal [MCP] extensor tendons) will occur by third decade of life in more than 60% of patients
Xanthelasmas