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Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Murmur with heart failure symptoms without any of the following 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 of infection (eg endocarditis, acute rheumatic fever)
      • signs of heart failure
    • 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 fever or rheumatic heart disease without concerning features

  • Category 2
    (appointment within 90 calendar days)
    • Moderate valve stenosis or regurgitation as described on echo report with normal ventricular function, and no pulmonary hypertension
  • Category 3
    (appointment within 365 calendar days)

    • Asymptomatic murmur not previously investigated

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

  • No essential requirements

3. Additional referral information Useful for processing the referral

  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • Past medical history (including acute rheumatic fever / rheumatic heart disease) and comorbidities
  • Family history of cardiac disease or sudden cardiac death
  • FBC, ELFTs, TSH, fasting lipids results
  • ECG
  • Echocardiogram report
  • CXR report
  • Include if appropriate gestational and development history
  • History of smoking, alcohol intake and drug use (including recreational drugs)
  • Aboriginal or Torres Strait Islander or Maori/Pacific Islander / Refugee status (increased risk of acute rheumatic fever and rheumatic heart disease)
  • Functional class (NYHA Class)

4. Request

Last updated: 22 June 2023