Heart failure
Red flags
Immediate referral to Emergency Department for patients with any of the following:
- signs and symptoms suggestive of acute heart failure (HF)
- decompensated chronic HF
- other cardiac event
Indications for immediate referral to emergency department include:
- recent myocardial infarct:
- within 2 weeks
- chest pain, where patient:
- currently has chest pain
- has had prolonged chest pain in the last 12 hours
- worsening angina
- acute pulmonary oedema:
- acute respiratory distress
- oxygen saturation < 90%
- agitation
- not responding to diuretics
- arrhythmia:
- associated with haemodynamic instability
- tachyarrhythmia, eg:
- fast atrial fibrillation (heart rate >100 bpm)
- ventricular tachycardia (VT) - does not always have associated haemodynamic instability
- new heart murmur
- hypotension – with evidence of end organ hypoperfusion, eg:
- dizziness/syncope
- altered level of consciousness
- agitation
- cool clammy skin
- renal dysfunction, eg:
- increasing creatinine
- BP < 90mmHg as a guide but compare to patient’s baseline
- syncope
- current pregnancy
It is important to perform an ECG but this should not delay the transfer of the patient to hospital. ECG changes may be seen suggestive of:
- ischaemia or infarct
- arrhythmia, particularly if there is haemodynamic instability.
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
- NYHA Class III heart failure with worsening symptoms but without Red flag
Category 2
Appointment within 90 days is desirable
- NYHA Class II heart failure with worsening symptoms
- Suspected or newly diagnosed heart failure
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
- The Heart Foundation’s Heart Failure Guidelines and the European Society of Cardiology guidelines provide some additional information regarding patient management
- Refer to HealthPathways for assessment and management information if available
Referral requirements
A referral may be rejected without the following information.
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
Login to Brisbane North Health Pathways:
brisbanenorth.