Emergency: If you have chest pain, pain in the jaw or left arm, sudden shortness of breath, sudden severe headache, weakness or numbness on one side of your face or body, or sudden difficulty speaking — go to your nearest emergency department immediately or call your scheme's emergency line. The number is on the back of your medical aid card. View AURA emergency contacts →
Hyperlipidaemia Itself Is Not an Emergency
High cholesterol is a silent condition. It does not cause sudden symptoms. The crisis that hyperlipidaemia causes is a cardiovascular event — a heart attack or stroke — that occurs when years of elevated LDL-C have caused enough plaque build-up in arteries to trigger a clot or rupture.
If you're reading this because your cholesterol number is high on a blood test: this is not a crisis. Contact your doctor and follow the newly diagnosed guide →.
If you're reading this because you or someone you're with is having a cardiac or neurological event: stop reading and get emergency help. The rest of this article is for after.
Scenario 1: Acute Myocardial Infarction (Heart Attack)
Prolonged elevated LDL-C accelerates atherosclerosis. A plaque in a coronary artery can rupture suddenly, triggering a clot that blocks blood flow to the heart muscle.
Symptoms: - Central chest pain, pressure, or tightness — may radiate to left arm, jaw, back, or abdomen - Shortness of breath - Sweating, nausea, dizziness - Sense of impending doom
Time is muscle. Every minute of blocked coronary artery means more heart muscle dies. "Door-to-balloon" time (from hospital arrival to opening the blocked artery) is the critical metric. Get to hospital. Don't wait.
In hospital: Emergency angiography and angioplasty (balloon + stent); or thrombolysis if catheterisation lab unavailable. Cardiologist-led care. ICU or high-care monitoring. This is expensive and specialist-intensive.
Scenario 2: Ischaemic Stroke
High LDL-C contributes to carotid artery and cerebral artery plaque. A clot in a cerebral artery causes an ischaemic stroke.
The FAST signs of stroke: - Face drooping — one side of the face droops or is numb - Arm weakness — one arm drifts down when both are raised - Speech — slurred, confused, unable to repeat a sentence - Time — call for emergency help immediately
Stroke treatment (IV thrombolysis or mechanical thrombectomy) is only possible within hours of symptom onset. Every minute counts.
Scenario 3: Pancreatitis From Very High Triglycerides
Severely elevated triglycerides (above 10–15 mmol/L) can cause acute pancreatitis — a medical emergency presenting as severe abdominal pain, vomiting, and elevated inflammatory markers. This is rare but life-threatening and requires emergency hospitalisation and ICU care.
The Gap Cover Picture for Lipid-Related Cardiovascular Events
| Event | Typical private hospital cost | Specialist shortfall risk |
|---|---|---|
| STEMI (heart attack with stenting) | R150,000–R250,000 | R15,000–R50,000 cardiologist shortfall |
| Ischaemic stroke (neurology + rehab) | R200,000–R350,000 | R20,000–R80,000 shortfall |
| Severe pancreatitis (ICU) | R100,000–R200,000 | R10,000–R30,000 shortfall |
These shortfalls arise because cardiologists, neurologists, neurosurgeons, and emergency physicians often bill above the medical scheme rate. Gap cover pays the difference. Without it, a cardiac admission in a private hospital can leave you with R15,000–R80,000 of unplanned personal debt on top of the medical and emotional trauma of the event itself.
What to Do If You're Already Admitted
- Call your scheme's pre-auth line within 24–48 hours (for planned events) or notify as soon as practical for emergencies. The number is on the back of your card.
- Make a note of every specialist who sees you — each bills separately and each may generate a separate gap claim.
- Request itemised accounts from hospital and each specialist.
- Submit your gap cover claim with supporting invoices, medical reports, and proof of scheme payment once accounts are finalised.
After the Event: Prevention of a Second Event
Secondary prevention after a cardiac event or stroke is aggressive and typically includes: - High-intensity statin (atorvastatin 40–80mg or rosuvastatin 20–40mg) — LDL-C target < 1.4–1.8 mmol/L - Dual antiplatelet therapy (aspirin + clopidogrel) for a defined period - Beta-blocker and ACE inhibitor after MI - Cardiac rehabilitation programme
All of these are CDL-funded. The challenge after a major cardiac event is adherence and follow-through, not cost.
Let's focus on what we can control: consistent medication, lifestyle changes, regular monitoring, and not missing follow-up appointments. The statin costs R55/month. The event cost R200,000. The maths is clear.
Check your scheme's cover for cardiac and stroke events →
If you are currently in a cardiac or neurological emergency, stop reading and get help immediately. Emergency contacts are on the back of your medical aid card. View AURA emergency contacts →