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Angina / Myocardial Ischaemia / chest pain

Red flags

Consider immediate urgent referral by ambulance with any of the following:

Symptoms

Suspected ischaemic chest pain within 12 hours that is either:

  • severe or ongoing
  • lasting 10 minutes or more
  • new at rest or with minimal activity
  • associated with severe dyspnoea
  • associated with syncope, presyncope

Signs (if associated with symptoms as above):

  • respiratory rate of more than 30 breaths per minute
  • tachycardia
  • systolic blood pressure less than 90 mmHg
  • heart failure/pulmonary oedema
  • Same-day assessment required if suspected acute cardiac pain occurred 12-72 hours ago. ECG (Suspected ischaemic chest pain within 12 hours)
  • ST elevation or depression and chest pain.
  • Complete heart block
  • New left bundle branch block

For patients with suspected acute coronary syndrome (ACS), within 12 hours of chest pain onset, arrange immediate emergency transfer to hospital by ambulance.

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • New recurrent cardiac chest pain without Red flags
  • Prolonged, severe, worsening pattern of angina without Red flags in patients with established coronary heart disease

Category 2

Appointment within 90 days is desirable

  • Chronic suspected cardiac chest pain without Red flags

Category 3

Appointment within 365 days is desirable

  • No Category 3 criteria

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

  • Refer to HealthPathways for assessment and management information if available

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • 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 cardiac disease or sudden cardiac death
  • FBC, ELFTs, fasting lipids, HbA1c (if diabetic) results
  • ECG

Additional Referral Information (Useful for processing the referral)

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

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.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Send referral

Hotline: 1300 364 938

Fax: 1300 364 952

Electronic: eReferral system

Mail: Metro North Central Patient Intake
Aspley Community Centre
776  Zillmere Road
ASPLEY QLD 4034

Health pathways

Access to Health Pathways is free for clinicians in Metro North Brisbane.

For login details email:
healthpathways@brisbanenorthphn.org.au

Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org

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Resources

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