Angina/Myocardial Ischaemia/Chest Pain

This condition is treated in the Cardiology clinic.

Pre-referral work-up

History

All referrals should comply with the Referral Standards. and must include:

• Details of relevant signs and symptoms
• Details of all treatments offered and efficacy
• Past medical history and comorbidities
• Patient's functional status
• Family history of cardiac disease or sudden cardiac death
• Smoking status

Tests

• FBC
• UEC
• LFT
• Lipids (chol, TG, HDL, LDL)
• HbA1c (if diabetic)
• Nil

Interim/GP management

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

Other information which may be useful for triage:

• Investigations relevant to significant comorbidities
• Cardiovascular risk assessment score
• Other investigations (if available) including CXR, cardiac imaging: stress test, stress echo or myocardial perfusion scan
• History of alcohol intake and drug use (including recreational drugs)

Interim management advice can be found on the Tasmanian Health Pathways website.

For more information please see the HealthPathways Tasmania website.

Additional Information

Please see:

• Heart Foundation website

Clinic appointments

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

Emergency

🚩 suspected acute coronary syndrome
🚩 suspected pulmonary embolism or aortic dissection
🚩 suspected or confirmed endocarditis, myocarditis, or pericarditis
🚩 suspected ischemic chest pain within 24 hours with any of the following concerning features:

• severe or ongoing chest pain
• chest pain that is new at rest or with minimal activity
• chest pain that is associated with severe dyspnoea
• chest pain that is associated with syncope/pre-syncope
• chest pain that is associated with any of the following signs:
• respiratory rate over 30 breaths per minute
• tachycardia over 120
• systolic BP under 90mmHg
• heart failure/suspected pulmonary oedema
• ST elevation or depression
• complete heart block
• new left bundle branch block

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

🚩New cardiac chest pain of a possible cardiac origin but without any of the listed Emergency Referral concerning features (select to display above)
🚩Worsening pattern of angina in patients with established coronary heart disease but without any of the listed Emergency Referral concerning features (select to display above)
🚩Low risk of cardiac chest pain with 3 or more cardiac risk factors (tick those that apply below)

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 (Category 2)

* Chronic chest pain of a suspected cardiac origin not previously investigated but without any of the listed Emergency Referral concerning features (select to display above)
* Low risk of cardiac chest pain with 2 or less cardiac risk factors (tick those that apply below):

Routine (Category 3)

Unlikely to be cardiac chest pain but no found cause for pain
Cardiac Risk Factors
For all selections, please also tick applicable cardiac risk factors:
- aged over 65 years
- hypertension
- diabetes
- dyslipidaemia
- current or recent smoking
- first degree relatives with premature coronary artery disease (men aged under 55 years and women aged under 65 years).

Next available appointment usually within eight weeks

Availability

North

Launceston General Hospital
Level 3 - Specialist Clinics

Phone: 1300 977 694
Fax: 03 6777 5227

North West

Mersey Community Hospital
Phone: 1800 636 455
Fax: 6441 5928

South

Wellington Clinics

General cardiology clinic enquiries and appointments:
Phone: 03 6166 0061
Fax: 03 6231 0101

Pacemaker and cardiac device enquiries and clinic appointments:
Phone: 03 6166 0064

Royal Hobart Hospital
Level 2 (D Block) - Cardiology and Echo Department

General cardiology clinic enquiries and appointments:
Phone: 03 6166 8620 or 03 6166 8860
Fax: 03 6234 3982

Nurse Practitioner: Chronic Cardiac Care/Heart Failure
Phone: 03 6166 7398

Pulmonary Hypertension Services
Phone: 03 6166 8034