Direct to an emergency department for:
- New acute, or chronic heart failure that is rapidly deteriorating, with any of the following:
- ongoing chest pain
- acute pulmonary oedema
- oxygen saturation < 94% (in the absence of any other reasons)
- haemodynamic instability
- syncope or pre-syncope
- recent myocardial infarction (within 2 weeks)
- pregnant or post-partum woman
- New heart failure that has not responded to initial and escalated treatment with diuretic therapy.
Criteria for referral to public hospital specialist clinic services
- Known heart failure with symptoms unresponsive to medical management (e.g. symptoms at rest, or on minimal exertion)
- New onset heart failure with reduced ejection fraction < 50% (HF-rEF) and structural or valvular heart disease
- New onset heart failure with preserved ejection fraction (HF-pEF) that have failed maximum tolerated diuretic treatment.
Information to be included in the referral
Information that must be provided
- Details of all relevant signs and symptoms
- 12 lead electrocardiogram (ECG) tracings from the last 12 months
- Echocardiogram report
- Any medicines previously tried, duration of trial and effect
- Current and complete medication history (including non-prescription medicines, herbs and supplements)
- Past medical history and comorbidities
- Liver function tests
- Urea and electrolyte results
- Full blood examination
- Thyroid stimulating hormone (TSH) level
- Fasting lipid profile results
- If diabetic, current and previous HbA1c results.
Provide if available
- New York Heart Association Functional Classification (NYHA) class status
- Chest x-ray
- Sleep studies
- Stress test
- Respiratory function tests (if the patient is a smoker or has chronic obstructive pulmonary disease or asthma)
- Previous 12 lead electrocardiogram (ECG) tracings
- Iron studies
- If the person identifies as an Aboriginal and Torres Strait Islander.
The Summary and referral information lists the information that should be included in a referral request.
The referral should include if this is a request for a second or subsequent opinion.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for
- Patients with asymptomatic heart failure with a stable ejection fraction > 50% (HF-pEF)
- Patients that are already under the care of a cardiologist.