Direct to an emergency department for:

  • Palpitations with any of the following:
    • shortness of breath
    • chest pain
    • heart failure
    • syncope, pre-syncope or loss of consciousness
    • persisting tachyarrhythmia on electrocardiogram (ECG).

Criteria for referral to public hospital specialist clinic services

  • Palpitations with any of the following:
    • abnormal electrocardiogram (ECG)
    • abnormal echocardiogram
    • other cardiac disease
    • functional impact of symptoms on daily activities including impact on work, study, or carer role
    • family history of sudden cardiac death or structural heart disease.

Information to be included in the referral

Information that must be provided

  • Details of all relevant signs and symptoms including the duration and frequency of the episodes of palpitations
  • Current and previous 12 lead electrocardiogram (ECG) tracings, particularly those during the episodes of palpitations
  • Current and complete medication history (including non-prescription medicines, herbs and supplements)
  • History of underlying cardiac disease
  • Any family history of sudden cardiac death
  • Urea and electrolyte results
  • Liver function tests
  • Thyroid stimulating hormone (TSH) level.

Provide if available

  • Details of previous hospital admissions or presentations to emergency department for palpitations
  • Holter monitor report
  • Echocardiogram report
  • If the person identifies as an Aboriginal and/or Torres Strait Islander
  • If symptoms are thought to be linked to probable or confirmed SARS CoV-2 (COVID-19) infection or Long COVID.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

The referral should note if the request is for a second or subsequent opinion as requests for a second opinion will usually not be accepted.

Note: there are also cardiology statewide referral criteria for Atrial fibrillation.

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 palpitations < 10 minutes duration without any other cardiac symptoms
  • Patients with sinus arrhythmia
  • Patients that are already under the care of a cardiologist.