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Cardiology · CPC
Heart failure
Hospital triage assigns the official category. Live source: Refer Your Patient — Heart failure.
Red flags — send to ED
Acute or chronic heart failure with any of the following concerning features — send to ED, not Category 1 outpatient.
- NYHA Class IV heart failure
- 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; systolic BP < 90 mmHg with hypoperfusion; systolic BP < 80 mmHg irrespective of symptoms
- Significant pulmonary or pedal oedema
- Recent myocardial infarction (within 2 weeks)
- Pregnant patient
- Signs of myocarditis
- Signs of acute decompensated heart failure
Early discussion with the patient’s usual heart failure team is advised for local care protocols.
ED fax numbers and emergency rules
CPC windows
Cat 1
Appointment within 30 calendar days
- Newly diagnosed NYHA Class III heart failure with worsening symptoms, without concerning features (those features are emergency — see red flags)
- Established heart failure on medical therapy with clinical signs of decompensation, without concerning features
Cat 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
Cat 3
Appointment within 365 calendar days
- Patients with established heart failure on optimal medical therapy requiring routine review i.e. take-over of care
If the patient does not meet the criteria but the referring practitioner believes specialist review is required, request a clinical override and explain why (warning signs, clinical modifiers, uncertain diagnosis). The referral may not be accepted or may be redirected.
Essential referral information
Referral will be returned without this. If a mandatory test cannot be obtained, say so in the referral.
- 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
Additional referral information
Useful if available — not the essential/return rule.
- Details of relevant signs and symptoms
- Details of all treatments offered and efficacy, and if referral is for a routine review / takeover 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 the patient is 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 Māori / Pacific Islander / refugee status (increased risk of acute rheumatic fever and rheumatic heart disease)
- Iron studies
Management notes
- Refer to HealthPathways for assessment and management information, or local guidelines if available.
- Heart failure may affect medical fitness to drive — see Queensland Transport and Austroads Assessing Fitness to Drive.
Send outpatient referrals to
- Smart Referrals preferred (Best Practice or Medical Director)
- Medical Objects GQ42150009Z (lookup qh → QHEALTH, GOLD COAST HEALTH OUTPATIENT)
- HealthLink EDI Qldgchsd
- Fax (07) 5687 4497 — Booking and Referral Centre
- Post: Booking and Referral Centre, Gold Coast University Hospital, 1 Hospital Boulevard, Southport QLD 4215
- Clinic enquiries 1300 559 083
How to refer — full order