Heart Failure

The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form.  This is part of routine waitlist auditing to ensure patient details are up to date.  If you receive this SMS, please update your details.

Availability

North South North West Statewide

Pre-referral work-up

History

Directly referral to the:

  • Heart Failure Clinic for complex and advanced heart failure;
  • Nurse Practitioner for established heart failure patients;
  • Patients with suspected heart failure should be referred to the general Cardiology Clinic

All referrals should comply to the Referral Standards and must include:

  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • Relevant previous medical history and co-morbidities
  • BP
  • Weight, height & BMI
  • Recent fluctuations in weight indicative of cardiac dysfunction (if known)

Tests

    Pathology:

  • FBC
  • UEC
  • LFT
  • Lipids
  • HbA1c (if diabetic)
  • TSH

    • Imaging:

  • CXR report

    • Investigations:

  • ECG
  • Most recent echocardiogram-if available

Interim/GP management

To refer a patient with this condition, please see the Cardiology clinic page for the full referral process and templates.

Additional information which may assist triage:

  • 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
  • BNP or NT-pro-BNP results (consider BNP for diagnostic dilemma, provide old results if available)
  • 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)
  • Iron studies

Interim management advice for heart failure can be found on HealthPathways.

For more information please see the Tasmanian Health Pathways website.

Emergency

Acute or chronic heart failure with any of the following concerning features:

  • Unable to carry on any physical activity without discomfort.  Symptoms of heart failure present at rest.
  • ongoing chest pain
  • increasing shortness of breath
  • oxygen saturation < 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 decompensated heart failure

Urgent / category 1

Newly diagnosed heart failure with worsening symptoms but without any emergency referral concerning features
Established heart failure on medical therapy with clinical signs of decompensation, but without any listed emergency referral concerning features

Semi-urgent / category 2

* Established heart failure on medical therapy with worsening symptoms but without clinical signs of decompensation or listed emergency referral concerning features
* Suspected or newly diagnosed left ventricular dysfunction with minimal/no symptoms or clinical evidence of decompensation

Routine / category 3

* Patients with established heart failure on optimal medical therapy requiring specialist review

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Additional Information

Heart Failure Nurse Practitioner contact details:
Sue Sanderson: Phone: (03) 6166 7398

Emergency:

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review.

We will endeavour to see these patients within one week, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within four weeks

Routine:

Next available appointment usually within eight weeks