Cardiology  |  Chest Pain Pathway - Chest Pain Clinic




Cardiology

Chest Pain Pathway - Chest Pain Clinic

For patients with chest pain and who can perform a treadmill ECG test - then a Chest Pain Clinic appointment will be appropriate - the consultation will be held in conjunction with a treadmill ECG test.


The following will assist with grading of referral and the information is requisite to the referral being accepted:

History must include:

  • characterization of pain
  • exacerbating or relieving factors
  • associated symptoms

 

List risk factors if available:

  • smoking
  • family history CAD - first degree male relative < 55 years / female < 65 years
  • calculate 5 year cardiovascular risk estimate

 

Is This Likely to be Angina? Indicate as to whether you think this likely to be angina.


Treadmill ECG Test:  
Indicate ability to perform this test - consider balance issues, arthritis, and claudication.


Important Co-morbidities:

Patient history of heart disease - the following are important:

  • Coronary arterial disease - past investigation or surgical intervention.
  • Known arrhythmia.
  • Heart failure.
  • Valvular heart disease.


Other:

  • Diabetes mellitus - higher risk and may present with atypical symptoms.
  • Hyperlipidaemia
  • Hypertension

 

Medication:  List current medications.

Other Medical History:  Detail any relevant medical history.

Examination:  Detail all relevant findings - include specifically BP and heart sounds.


Investigations:

  • Detail relevant lab investigations - include specifically FBC, creatinine, electrolytes, TFT, lipids, glucose, HbA1c.
  • ECG must be done.
  • Copy forwarded of ECG or report abnormal findings - look for AF, past MI, LVH.


Social:
 
Advise any important social implications.
  • It is mandatory for a medical practitioner to advise patient of legal driving restrictions'.
  • Medical Aspects of Driving.
  • Indicate if driving essential to employment.
  • Indicate if at risk in present living arrangements.


Last updated : Thursday, September 10, 2015
Next review date : Friday, September 09,2016


Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.