Heart Failure

This condition is treated in the Cardiology clinic.

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

• FBC
• UEC
• LFT
• Lipids
• HbA1c (if diabetic)
• TSH
• CXR report
• 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 HealthPathways Tasmania website.

Additional Information

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

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

🚩 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 under 90%
• signs of acute pulmonary oedema
• haemodynamic instability:
  • pre-syncope / syncope / severe dizziness
  • altered level of consciousness
  • heart rate over 120 beats per minute
  • systolic BP under 90mmHg
• significant pulmonary or pedal oedema
• recent myocardial infarction (within 2 weeks)
• pregnant patient
• signs of myocarditis
• signs of acute decompensated heart failure

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)

🚩 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

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)

* 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

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