Heart failure

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Useful Management Information

The Heart Foundation’s Heart Failure Guidelines and the European Society of Cardiology guidelines provide some additional information regarding patient management

Minimum Referral Criteria

Category 1	NYHA Class III heart failure with worsening symptoms but without concerning features* *Concerning features: NYHA Class IV heart failure Ongoing chest pain Increasing shortness of breath Oxygen saturation of <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 decompensation heart failure
Category 2	NYHA Class II heart failure with worsening symptoms Suspected or newly diagnoses heart failure
Category 3	No category 3 criteria
If your patient doesn't meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: 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.

Standard Referral Information

Reason for request

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

Relevant clinical information about the condition

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
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

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.)

Essential Referral Information

Details of relevant signs or symptoms
Details of all treatments offered and efficacy
Relevant previous medical history and co-morbidities
BP
Weight, height and 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 results
ECG
CXR report

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referra

Additional Referral Information

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
B-type Natriuretic Peptide (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
Iron studies

Send Referrals To

Smart Referrals

Coming Soon

Internal Referrals

Cardiology (E-Blueslips)

Fax

5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Service Availability

Facilities

Gold Coast University Hospital

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.