Murmur

This condition is treated in the Cardiology clinic.

Pre-referral work-up

History

Direct Referral to Cardiology Clinic

All referrals should comply to the referral standards and must include:

• Physical findings including colour assessment or oxygen saturation
• Report presence or absence of the following:
  • - History of exercise intolerance
  • - Cyanotic episodes or blue spells
  • - Weak or absent femoral pulses
  • - Clubbing

Highly desirable information - may change triage category

• Known other congenital abnormalities
• Family history of congenital cardiac disease
• Aboriginal or Torres Strait Islander or Maori status (acute rheumatic fever / rheumatic heart disease risk)

Tests

Pathology:

• FBC
• UEC
• TFT

Imaging:

• Nil

Investigations:

• Any relevant e.g. echocardiogram report

Interim/GP management

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

Desirable information - will assist at consultation

• Other past medical history
• Immunisation history
• Developmental history
• Medication history
• Significant psychosocial risk factors (especially parent's mental health, family violence, housing and financial stress, department of child safety involvement).
• Height/weight/head circumference and growth charts with prior measurements if available.
• Other physical examination findings inclusive of CNS, birth marks or dysmorphology.
• Any relevant laboratory results or medical imaging reports, urinalysis result.

Interim management advice for Heart Murmurs in Adults can be found on HealthPathways.

For more information please see the HealthPathways Tasmania 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

🚩 New murmur with any of the following concerning features:

• haemodynamic instability
• persistent or progressive shortness of breath with marked limitation of physical activity or worse.
• 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

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)

🚩 Murmur with heart failure symptoms without emergency referral concerning features

🚩 Severe valve stenosis or regurgitation as described on echo report without emergency referral concerning features

🚩 Stenosis or regurgitation with left ventricular dysfunction and/or pulmonary hypertension without emergency referral concerning features

🚩 Previous valve surgery with new heart failure symptoms without emergency referral concerning features

🚩 New or worsening heart failure symptoms in patient with a history of rheumatic fever or rheumatic heart disease without 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)

* Moderate valve stenosis or regurgitation as described on echo report with normal ventricular function, and no pulmonary hypertension

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