Murmur

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Useful Management Information

If structural heart disease is suspected an echocardiogram should be arranged

Minimum Referral Criteria

Category 1	Murmur with heart failure symptoms without concerning features* Severe valve stenosis or regurgitation as described 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 heart disease without concerning features* *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 or infection (e.g. endocarditis, acute rheumatic fever) Signs of heart failure
Category 2	Moderate valve stenosis or regurgitation as described on echo report with normal ventricular function, and no pulmonary hypertension
Category 3	Asymptomatic murmur not previously investigated.
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
Past medical history (including acute rheumatic fever/rheumatic heart disease) and co-morbidities
Family history of cardiac disease or sudden cardiac death (if relevant)
FBC
ELFTs
TSH results
Fasting Lipids results

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 referral

Additional Referral Information

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

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.