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.

Additional comments

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.