Cardiology

Conditions

Cardiology services are provided at 4 locations within the Metro North area by the Department of Cardiology. These hospitals are, Royal Brisbane and Women’s Hospital, The Prince Charles Hospital, Caboolture Hospital and Redcliffe Hospital. Patients will be allocated to the various facilities based on their postcode, the availability of particular services at those facilities and to improve equity of access across the district.

Paediatric services

Referrals for children and young people should follow the Children’s Health Queensland referral guidelines.

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

Atrial fibrillation

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

Chest pain

• Suspected acute coronary syndrome
• Suspected pulmonary embolism or aortic dissection
• Suspected or confirmed endocarditis, myocarditis or pericarditis
• Suspected ischaemic chest pain within 24 hours with any of the following Red flags
• 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

Heart failure

• Acute or chronic heart failure with any of the following Red flags
• 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
• signs of myocarditis
• signs of acute decompensated heart failure

Hypertension

• Hypertensive emergency (BP>220/140)
• Severe hypertensive with systolic BP >180mmHg with any of the following Red flags
  • headache
  • confusion
  • blurred vision
  • retinal haemorrhage
  • reduced level of consciousness
  • seizures
  • proteinuria
  • papilloedema

If suspected pregnancy induced hypertension or pre-eclampsia refer patient to the emergency department of a facility that offers obstetric services where possible

Murmur

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

Palpitations

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

Syncope / pre-syncope

• Syncope with any of the following Red flags
  • exertional onset
  • chest pain
  • persistent hypotension (systolic BP <90mmHg)
  • severe persistent headache
  • focal neurological deficits preceded by or associated with palpitations
  • persisting tachyarrhythmia on ECG
  • known ischaemic heart disease or reduced LV systolic function associated with SVT or paroxysmal atrial fibrillation
  • pre-excited 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

Please note that the following services are available through the Metro North Cardiology Department:

Adult General Cardiology and Interventional

• Coronary angiogram
• Coronary angioplasty
• Coronary artery disease
• Echocardiography
• Ischaemic heart disease
• Left atrial appendage occlusion
• Pacing and defibrillation
• Percutaneous valve replacement
• Pericardial disease
• Prosthetic heart valve
• Structural heart disease (ASD/PFO)
• Valvular heart disease
• Valvuloplasty
• Peripheral vascular disease

The Prince Charles Hospital

• Ischaemic heart disease including coronary angiography and angioplasty
• Electrophysiology
• Advanced heart failure including mechanical cardiac support (Ventricular Assist Devices)
• Heart transplant
• Structural heart disease
• Adult congenital heart disease
• Adult congenital heart disease 13 years +
• Murmurs
• Septal defects
• Valve abnormalities
• Echocardiography
• Telehealth
• Peripheral vascular intervention

Royal Brisbane and Women’s Hospital

• Coronary angiogram
• Coronary angioplasty
• Coronary artery disease
• Echocardiography
• Ischaemic heart disease
• Pacing and defibrillation
• Cardiomyopathy
• Cardiac genetics
• Cardiac obstetrics
• Electrophysiology
• Heart failure

Special facilities

Please note that special accommodation (Medihotel) is available on site at The Prince Charles Hospital for the use of patients from out of town requiring investigations and or review spread over more than one day.

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Specialists list