Heart failure

ADULT

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

    Heart failure

    • Acute or chronic heart failure with any of the following concerning features:
      • NYHA Class IV heart failure (PDF, 101kB)
      • ongoing chest pain
      • significant orthopnoea/PND
      • oxygen saturation < 90%
      • clinical and/or radiographic 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 with symptoms of hypoperfusion
        • systolic BP < 80mmHg irrespective of symptoms
      • significant pulmonary or pedal oedema
      • recent myocardial infarction
      • pregnant patient
      • signs of myocarditis
      • signs of acute decompensated heart failure

    NB: Early discussion with the patient’s usual heart failure team would be advised for local care protocols.

Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Newly diagnosed heart failure with worsening symptoms but without any of the following concerning features
    • NYHA Class IV heart failure (PDF, 101kB)
    • ongoing chest pain
    • significant orthopnoea/PND
    • oxygen saturation < 90%
    • clinical and/or radiographic 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 with symptoms of hypoperfusion
      • systolic BP < 80mmHg irrespective of symptoms
    • significant pulmonary or pedal oedema
    • recent myocardial infarction
    • pregnant patient
    • signs of myocarditis
    • signs of acute decompensated heart failure
  • Established heart failure on medical therapy with clinical signs of decompensation, but without concerning features
Category 2
(appointment within 90 calendar days)
  • Established heart failure on medical therapy with worsening symptoms but without clinical signs of decompensation or concerning features
  • Suspected or newly diagnosed left ventricular dysfunction with minimal/no symptoms or clinical evidence of decompensation
Category 3
(appointment within 365 calendar days)

  • Patients with established heart failure on optimal medical therapy requiring routine review i.e., take-over of care

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • 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

2. Essential referral information Referral will be returned without this

3. Additional referral information Useful for processing the referral

  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy and if referral is for a routine review/take-over of care
  • Relevant previous medical history and co-morbidities
  • Sleep study report if OSA suspected
  • Stress test report (if performed)
  • ECG (if available)
  • CXR report (if available)
  • Investigations relevant to co-morbidities
  • Respiratory function tests if patient a smoker, has COPD or asthma
  • Echocardiogram report
  • BNP or NT-pro-BNP results
  • History of smoking, alcohol intake and drug use (including recreational drugs)
  • Aboriginal or Torres Strait Islander or Màori/Pacific Islander / Refugee status (increased risk of acute rheumatic fever and rheumatic heart disease)
  • Iron studies

4. Request

  • Patient's demographic details

    • 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

    Referring practitioner details

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

    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
    • 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

    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

    Clinical modifiers

    • 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

    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.)

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

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
    • A change in patient circumstance (such as condition deteriorating or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 12 December 2025

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