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Cardiology - Public Patients

Purpose

This  page contains information for general practitioners on how to refer patients aged 16 years and over to Cardiology services at Mater Hospital Brisbane

Service 

The Cardiology service is led by Dr Karam Kostner, who operates a state-wide tertiary service for the management and treatment of lipid disorders. The service offers a multidisciplinary approach to cardiac care including nurse-led clinics for heart failure optimisation and smoking cessation. Patients have access to allied health services including physiotherapy, psychology, social work, occupational therapy and dietetics. Due to being located on campus with the Mater Mother's Hospitals, the Cardiology service also offers specialised assessment and treatment for women with cardiac disorders in pregnancy.

Patients can also be referred directly by their GP to the Cardiovascular Investigations Unit for Echo, EST and Holters.

Other investigations performed on site by the Cardiac Investigations Unit include Stress Echo, Dobutamine Stress Echo, Transoespohageal Echo, ECG, Vascular Imaging such as Carotid and peripheral ultrasound, angiography and angioplasty and right heart catheters following review by a cardiologist. 

How to refer

If referral for care is indicated please list all of the General Referral Information and reason for request, and essential information as indicated below.

To refer, please fill in the Mater Adult Referral Form, available to download and embed into most major Practice Management software applications.

Referrals can be sent by:

Secure messaging        Medical Objects:   HM4101000R8

                                  HealthLink EDI:    materref                                                                                             

Fax                             07 3163 8548

Emergency

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergency medical advice if in a remote region:

View list of conditions

Chest Pain

  • Suspected pulmonary embolism or aortic dissection
  • Suspected acute coronary syndrome
  • Suspected or confirmed endocarditis, myocarditis or pericarditis
  • Suspected ischaemic chest pain within 24 hours with any of the following concerning features:
    • Chest pain that is:
      • severe or ongoing
      • lasting ten minutes or more
      • new at rest or with minimal activity
      • associated with severe dyspnoea
      • associated with syncope / pre-syncope
      • associated with any of the following signs:
        • respiratory rate > 30 breaths per minute
        • tachycardia >120
        • systolic BP <90mmHg
        • heart failure / suspected pulmonary oedema
        • ST elevation or depression
        • complete heart block
        • new left bundle branch block

Artrial Fibrillation

  • Atrial fibrillation / flutter with any of the following concerning features
    • haemodynamic instability
    • shortness of breath
    • chest pain
    • syncope/pre syncope/dizziness
    • known Wolff-Parkinson-White
    • neurological deficit indicative of TIA/stroke

Heart Failure

  • Acute or chronic heart failure with any of the following concerning features
    • NYHA Class IV heart failure
    • ongoing chest pain.
    • increasing shortness of breath.
    • oxygen saturation < 90%.
    • signs of acute pulmonary oedema
    • haemodynamic instability:
      • pre-syncope / syncope / severe dizziness
      • altered level of consciousness
      • heart rate > 120 beats per minute
      • systolic BP < 90mmHg
    • significant pulmonary or pedal oedema
    • recent myocardial infarction (within 2 weeks)
    • pregnant patient
    • sign of myocarditis
    • sign of acute decompensated heart failure

Hypertension

  • Hypertensive emergency (BP >220/140)
  • Severe Hypertensive with systolic BP >180mmHg with any of the following concerning features:
    • headache
    • confusion
    • blurred vision
    • retinal haemorrhage
    • reduced level of consciousness
    • seizures
    • proteinuria
    • papilloedema
  • If suspected pregnancy include hypertension or pre-eclampsia refer patient to the emergency department of a facility that offers obstetrics services where possible.

Murmur

  •  New murmur with any of the following concerning features:
    • haemodynamic instability
    • persistent or progressive shortness of breath (NYHA Class III - IV)
    • chest pain
    • syncope/pre-syncope/dizziness
    • neurological deficit indicative of TIA Stroke
    • abnormal ECG (e.g. LV hypertrophy, AF, LBBB, RBBB)
    • fever or constitutional symptoms suggestive of infection (e.g. endocarditis, acute rheumatic fever)
    • signs of heart failure

Palpitations

  • Palpitations with any of the following concerning features:
    • chest pain
    • shortness of breath
    • loss of consciousness
    • syncope / pre-syncope
    • persisting tachyarrhythmia on ECG

Supraventricular tachycardia:

  • Unresolved acute supraventricular tachycardia with any of the following concerning features:
    • syncope
    • severe dizziness
    • ongoing chest pain
    • increasing shortness of breath
    • hypotension
    • signs of cardiac failure
    • ventricular rate >120

Syncope/ Pre-syncope:

  • Syncope with any of the following concerning features:
    • exertional onset
    • chest pain
    • persistent hypotension (systolic BP <90mmHg)
    • severe persistent headache
    • focal neurologic deficits
    • preceded by or associated with palpitations
    • associated with SVT or paroxysmal atrial fibrillation
    • known ischaemic heart disease with reduced LV systolic function
    • pre-existed QRS (delta waves) on ECG
    • suspected malfunction of pacemaker or ICD
    • absence of prodrome
    • associated injury
    • occurs while supine or sitting

Other

  • Pacemaker/ICD
    • Delivery of 2 or more shocks by ICD in 24 hours
    • Suspected pacemaker/defibrillator malfunction (with ECG evidence)
    • pacemaker/ICD device erosion
  • Bradycardia including any of the following:
    • symptomatic bradycardia
    • PR interval on ECG exceeding 300ms
    • second degree or complete heart block
  • Broad complex tachycardia
  • Suspected or confirmed endocarditis, myocarditis or pericarditis

 

Scope of Service

Conditions in scope:

Adult Congenital Cardiac Disorders

Essential information (Referral will be declined without this)

  • General Referral Information
  • As much detail as possible about the patient’s personal history of disease including the following:
    • clear indication of clinical need for urgency (see above)
    • clinical diagnosis and features
    • age at diagnosis
    • treatment (completed and planned)
    • relevant pathology (if results are available on Auslab please indicate this on referral)
    • relevant organ specific diagnostic investigations and/or imaging results (especially ECG, MRI and echocardiogram) (if results are available within ieMR please indicate this on referral)
    • details and results of genetic testing if performed
  • Presence or absence of relevant family (blood relatives) history

Additional referral information (useful for processing the referral)

  • Known details of relevant family history (first and second degree blood relatives including:
    • clinical diagnosis/features and age at diagnosis
    • relation to patient including whether maternal or paternal
    • autopsy reports (where relevant and available)

Other useful information for management (not an exhaustive list)

    • The offer of an appointment by GHQ does NOT guarantee that the patient will be offered a publicly funded genetic test.
    • If there are any queries regarding the appropriateness of a referral please contact GHQ.
    • If the patient is an UNTESTED blood relative of a person with an identified gene mutation/chromosomal anomaly, please refer to the following CPC:
    • Patients will be asked to provide detailed family information either during a telephone consultation or via a family history questionnaire. One or more ‘Consent to Release information’ forms may be provided to forward to family members to obtain their consent to confirm details of the reported family history.
    • The Queensland Cardiac Genetics Service is a collaborative multidisciplinary clinical service with both cardiology and clinical genetics staff in attendance. The clinics are primarily based at the Royal Brisbane and Women's Hospital (adult) and Queensland Children’s Hospital (children), however regional clinics and telehealth appointments are also available.
    • Examples of conditions where individuals might be referred include a confirmed or suspected diagnosis/family history of:
      • ascending aortic aneurysm/aortopathy/vasculopathy
      • hypertrophic cardiomyopathy
      • arrhythmogenic right ventricular cardiomyopathy (ARVC)
      • left ventricular non-compaction (LVNC)
      • dilated cardiomyopathy
      • long QT syndrome
      • catecholaminergic polymorphic ventricular tachycardia (CPVT)
      • Brugada syndrome
      • sudden unexplained death in a young relative (less than 40 years of age)
      • familial hypercholesterolaemia
      • paediatric pulmonary hypertension
      • Marfan syndrome (please ensure an echocardiogram and ophthalmology review has been requested)
      • congenital heart defect

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – Urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

The patient has a personal and/or any family history (blood relatives) of a cardiac genetic diagnosis AND the patient or their partner is pregnant and an opinion/genetic testing will guide investigations, management, and outcome in pregnancy

  • The patient has a personal history of a cardiac genetic diagnosis AND is currently on or about to go onto a palliative care pathway
  • The patient has a personal and/or any family history (blood relatives) of a cardiac genetic diagnosis, where a specific gene mutation HAS been identified on a genetic test

 

The patient has a personal and/or any family history (blood relatives) of a cardiac genetic diagnosis, where a specific gene mutation has NOT been identified on a genetic test

 

Angina / Myocardial Ischaemia / Chest Pain

Essential information (Referral will be declined without this)

  • General Referral Information
  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • Past medical history and comorbidities
  • Patient’s functional status
  • Family history of premature cardiac disease or sudden cardiac death
  • FBC, ELFTs, fasting lipids, HbA1c (if diabetic) results
  • ECG

Additional referral information (useful for processing the referral)

  • Investigations relevant to significant comorbidities
  • Cardiovascular risk assessment score
  • Other investigations (if available) including CXR, cardiac imaging: stress ECG, stress echo or myocardial perfusion scan
  • History of smoking and drug use (including alcohol)

Other useful information for management (not an exhaustive list)

  • No additional information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – Urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

New recurrent cardiac chest pain without concerning features:

  • severe or ongoing chest pain
  • chest pain that is lasting ten minutes or more
  • chest pain that is new at rest or with minimal activity
  • chest pain associated with severe dyspnoea
  • chest pain that is associated with syncope / pre-syncope
  • chest pain that is associated with any of the following signs:
    • respiratory rate > 30 breaths per minute
    • tachycardia >120
    • systolic BP <90mmHg
    • heart failure / suspected pulmonary oedema
    • ST elevation or depression
    • complete heart block
    • new left bundle branch block

Prolonged, severe, worsening pattern of angina without concerning features in patients with established coronary heart disease

Chronic suspected cardiac chest pain without concerning features for investigation

No category 3 criteria

 

Atrial Fibrillation / Flutter

Essential information (Referral will be declined without this)

  • General Referral Information
  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • Past medical history and comorbidities
  • Family history of sudden cardiac death
  • FBC, ELFTs, TSH, magnesium
  • All available ECGs (including ECG showing arrhythmia)

Additional referral information (useful for processing the referral)

  • Any investigations relevant to any co-morbidities
  • Other investigations (if available) eg echocardiogram report, CXR report, holter monitor report, sleep study report
  • History of smoking, alcohol intake and drug use (including recreational drug use)
  • Coagulation studies, fasting lipid results
  • CHADS VASC score

Other useful information for management (not an exhaustive list)

  • Not all patients have to be seen by a cardiologist if the general practitioner is comfortable caring for the patient
  • In patients with new onset atrial arrhythmias (<48 hours), consider a fast track approach via telephone contact with the nearest cardiology service for consideration of earlier cardioversion to minimize the burden of atrial arrhythmia.

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – Urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

New atrial fibrillation/flutter without concerning features:

  • haemodynamic instability
  • shortness of breath
  • chest pain
  • syncope/pre syncope/dizziness
  • known Wolff-Parkinson-White
  • neurological deficit indicative of TIA/stroke

Recurrent paroxysmal atrial fibrillation / flutter

Atrial fibrillation with signs of heart failure or reduced LV function that does not require presentation to Emergency 

Chronic atrial fibrillation requiring management review (e.g. rate control, anticoagulation)

No category 3 criteria

 

Cardiac Conditions in Pregnancy

Essential information (Referral will be declined without this)

  • General Referral Information
  • Cardiac history
  • Symptoms e.g. syncope, pre-syncope, palpitations, clamminess
  • Relevant imaging
  • Previously performed cardiac investigations (ECG, ECHO, stress test, chest x-ray)
  • Pregnancy Details
    • gestational age
    • expected date of delivery
    • previous pregnancies

Additional referral information (useful for processing the referral)

  • Nil additional information

Other useful information for management (not an exhaustive list)

  • Nil additional information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – Urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Category is determined by stage of pregnancy and condition / symptoms / severity

Category is determined by stage of pregnancy and condition / symptoms / severity

Category is determined by stage of pregnancy and condition / symptoms / severity

 

Heart Failure

Essential information (Referral will be declined without this)

  • General Referral Information
  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • Relevant previous medical history and co-morbidities
  • BP
  • Weight, height & BMI
  • Recent fluctuations in weight indicative of cardiac dysfunction (if known)
  • New York Heart Association (NYHA) class
  • FBC, ELFTs, fasting lipids, HbA1c (if diabetic), TSH,
  • ECG
  • CXR report

Additional referral information (useful for processing the referral)

  • Sleep study report if OSA suspected
  • Stress test report (if performed)
  • Investigations relevant to co-morbidities
  • Respiratory function tests if patient a smoker, has COPD or asthma
  • Echocardiogram report
  • BNP or NT-pro-BNP results
  • History of smoking, alcohol intake and drug use (including recreational drugs)
  • Aboriginal or Torres Strait Islander or Maori / Pacific Islander / Refugee status (increased risk of acute rheumatic fever and rheumatic heart disease)
  • Iron studies 

Other useful information for management (not an exhaustive list)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Heart failure NYHA Class III with worsening symptoms but without concerning features:

  • NYHA Class IV heart failure
  • ongoing chest pain.
  • increasing shortness of breath.
  • oxygen saturation < 90%.
  • signs of acute pulmonary oedema
  • haemodynamic instability:
    • pre-syncope / syncope / severe dizziness
    • altered level of consciousness
    • heart rate > 120 beats per minute
    • systolic BP < 90mmHg
  • significant pulmonary or pedal oedema
  • recent myocardial infarction (within 2 weeks)
  • pregnant patient
  • sign of myocarditis
  • sign of acute decompensated heart failure

 

 

 

 

NYHA Class II heart failure with worsening symptoms

Newly diagnosed or suspected heart failure

No category 3 criteria

 

Hypertension (Cardiology)

Essential information (Referral will be declined without this)

  • General Referral Information
  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • BP (BP measurements on both arms preferable)
  • Relevant previous medical history and co-morbidities
  • FBC, ELFTs, eGFR, fasting lipids results
  • Urinalysis results
  • Urinary protein estimation results or albumin creatinine ratio
  • CXR report
  • ECG

Additional referral information (useful for processing the referral)

  • Any investigations relevant to co-morbidities
  • Stress test report (if available)
  • Renal duplex report if renal artery stenosis suspected
  • Smoking, alcohol intake and drug use (including recreational drugs)

Other useful information for management (not an exhaustive list)

  • Consider testing for primary hyperaldosteronism, and phaeochromocytoma
  • Refer to HealthPathways for assessment and management information if available.
  • The Heart Foundation’s Hypertension Guidelines provide some additional guidance for patient management

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Severe persistent hypertension (>180/110) without concerning features:

  • headache
  • confusion
  • blurred vision
  • retinal haemorrhage
  • reduced level of consciousness
  • seizures
  • proteinuria
  • papilloedema

Hypertension that persists after trial of oral medications as described by the Heart Foundation Hypertension

 

 

Medication intolerance

Suspected renal artery stenosis (consider referral to vascular if available)

Refractory hypertension patients on three or more medications with BP >140/90

Changing pattern of hypertension

 

Lipid Disorders

Essential information (Referral will be declined without this)

  • General Referral Information
  • Details of all treatments offered and efficacy
  • Relevant previous medical history and co-morbidities (especially cardiovascular disease)
  • BP
  • ELFTs, HbA1c, TSH, CK results
  • Recent (within 3 months) fasting lipid results (cholesterol/ triglyceride/ HDL-cholesterol/ LDL-cholesterol)

Additional referral information (useful for processing the referral)

  • Smoking and alcohol history
  • Family history of hyperlipidaemia
  • Previous lipid results (serial if available)
  • Any imaging confirming presence of cardiovascular disease
  • Coronary artery calcium score

Other useful information for management (not an exhaustive list)

  • Consider commencing statins depending on  other cardiac risk factors
  • The Heart Foundation’s Lipid Management Guidelines provide some additional guidance for patient management
  • The QRISK®2 calculator is helpful in assessing cardiovascular disease risk
  • Patients with moderate hyperlipidaemia (total cholesterol 5 – 10mmol/L and/or triglycerides < 4mmol/L) may be referred to a general physician rather than a cardiologist depending on local services.

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Total triglyceride > 20 mmol/l in patient having had episode of pancreatitis in the previous 3 months (consider referring to Mater Diabetes and Endocrinology service

 

 

Patients with prior ACS and:

  • LDL >5.00mmol/L or 
  • DLNC Score > 6 (ie likely heterozygous family history) 

Significantly raised LSL (> 4 mmol/L in high CVD risk patients 

Difficult to control LDL (> 3.3 mmol/L) in CHD patients with familial hypercholesterolemia 

Severe mixed dyslipidaemia (TC and TG totalling more than 10 mmol/L) 

 

Murmurs

Essential information (Referral will be declined without this)

  • General Referral Information
  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • Past medical history (including rheumatic fever) and comorbidities
  • Family history of cardiac disease or sudden cardiac death
  • FBC, ELFTs, TSH, fasting lipids results

Additional referral information (useful for processing the referral)

  • Echocardiogram report
  • CXR report
  • Include if appropriate gestational and development history
  • History of smoking, alcohol intake and drug use (including recreational drugs)
  • ECG
  • Aboriginal or Torres Strait Islander or Maori / Pacific Islander / Refugee status (increased risk of acute rheumatic fever and rheumatic heart disease)
  • Functional class NYHA Class

Other useful information for management (not an exhaustive list)

  • If structural heart disease is suspected an echocardiogram should be arranged 

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Murmur with heart failure symptoms without concerning features:

  • haemodynamic instability
  • persistent or progressive shortness of breath (NYHA Class III - IV)
  • chest pain
  • syncope/pre-syncope/dizziness
  • neurological deficit indicative of TIA Stroke
  • abnormal ECG (e.g. LV hypertrophy, AF, LBBB, RBBB)
  • fever or constitutional symptoms suggestive of infection (e.g. endocarditis, acute rheumatic fever)
  • signs of heart failure

Severe valve stenosis or regurgitation on echo report without concerning features

Stenosis or regurgitation with left ventricular dysfunction and/or pulmonary hypertension without concerning features

Previous valve surgery with new heart failure symptoms without concerning features.

New or worsening heart failure symptoms in patient with a history of rheumatic fever or rheumatic heart disease without concerning features

 

Moderate valve stenosis or regurgitation  with normal ventricular function, and no pulmonary hypertension

Asymptomatic murmur not previously investigated 

 

Palpitations

Essential information (Referral will be declined without this)

  • General Referral Information
  • Details of relevant signs and symptoms including duration and frequency of episodes
  • History of underlying cardiac disease
  • Family history of sudden cardiac death
  • ELFTs, TSH and Magnesium  results
  • All available ECGs (during episodes if possible)

Additional referral information (useful for processing the referral)

  • Holter monitor report and all ECG tracings (useful if symptoms are present on almost a daily basis) 
  • Echocardiogram report
  • Stress test report 
  • Caffeine intake, alcohol intake and drug use (including recreational drugs)
  • Aboriginal or Torres Strait Islander or Maori / Pacific Islander / Refugee status (increased risk of acute rheumatic fever and rheumatic heart disease)

Other useful information for management (not an exhaustive list)

  • ECG at the time of palpitation (even if normal) may have important diagnostic clues

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Palpitations with any of the following:

  • other cardiac symptoms
  • haemodynamic disturbance
  • abnormal ECG

No category 2 criteria

Palpitations that do not meet criteria for Emergency or Category 1

 

Syncope / Pre-Syncope

Essential information (Referral will be declined without this)

  • General Referral Information
  • Details of all treatments offered and efficacy
  • Relevant medical history
  • Description of syncopal / pre-syncopal events (consider timeline, precipitating factors, any warning pre-syncopal symptoms, complete LOC or partial, duration of LOC, nature of recovery, witnessed signs, seizures, pallor, incontinence, cyanosis, irregular or absent pulse during attack, associated injury).
  • Lying / standing or sitting / standing BP
  • Family history of sudden cardiac death or premature coronary artery disease
  • Presence of impaired LV function by any imaging modality (MRI, echo or MPS) if known
  • FBC, TSH, ELFTs, magnesium results
  • All available ECGs       

Additional referral information (useful for processing the referral)

  • Holter monitor report (only useful if frequent symptoms)
  • Echocardiogram report
  • CXR report    
  • History of drug use (including recreational drugs) 

Other useful information for management (not an exhaustive list)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

New episode(s) of uninvestigated syncope / near syncope without concerning features:

  • exertional onset
  • chest pain
  • persistent hypotension (systolic BP <90mmHg)
  • severe persistent headache
  • focal neurologic deficits
  • preceded by or associated with palpitations
  • associated with SVT or paroxysmal atrial fibrillation
  • known ischaemic heart disease with reduced LV systolic function
  • pre-existed QRS (delta waves) on ECG
  • suspected malfunction of pacemaker or ICD
  • absence of prodrome
  • associated injury
  • occurs while supine or sitting

 

Recurrent syncope previously investigated with undetermined cause         

No category 3 criteria     

 

Supraventricular tachycardia

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • Relevant previous medical history and co-morbidities
  • Caffeine intake, alcohol intake and drug use (including recreational drugs)
  • Echocardiogram report
  • Stress test report
  • CXR report

Other useful information for management (not an exhaustive list)

  • If isolated in the absence of syncope/ haemodynamic compromise:
    • reassure
    • consider vagolytic manoeuvres
  • Consider holter monitor if frequent (daily or second daily)
  • Consider event recorder if infrequent

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

 

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Supraventricular tachycardia without concerning features:

  • syncope
  • severe dizziness
  • ongoing chest pain
  • increasing shortness of breath
  • hypotension
  • signs of cardiac failure
  • ventricular rate >120

 

Documented evidence of pre-excitation on ECG with history of palpitations       

No category 3 criteria     

 


Our Specialists

A/Prof. Karam Kostner

Director of Cardiology - general cardiology, imaging, primary prevention and lipid disorders

Dr Adrian Chong

Cardiologist - general cardiology, imaging

Dr Mugurel Nikolai

Cardiologist - general cardiology, adult congenital heart disease

Dr Przemek Palka

Cardiologist - general cardiology, imaging 

Kerry Anne Creevey

Heart Failure nurse

Paul Camp

Cardiac rehab Nurse

 

Bulk Billed Clinics

Mater Health Services offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed specialist clinic, please provide a named referral to one of our specialists listed above.

Contact Us

If you would like to discuss a referral, including clinical criteria, or update the status of a current patient please contact our priority GP phone line on 07 3163 2200.  

Current Waiting Time for Appointments

We provide up to date data on how long patients are waiting for their clinic first appointment by specialty here.

Referral Guideline Development

These Mater Referral Guidelines have been developed locally by GPs and specialists to support safe and quality referral to publicly funded specialist outpatient services.

 

Content last reviewed: 01 May 2019

 

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