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:
- 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.
Patient history of heart disease - the following are important:
- Coronary arterial disease - past investigation or surgical intervention.
- Known arrhythmia.
- Heart failure.
- Valvular heart disease.
- Diabetes mellitus - higher risk and may present with atypical symptoms.
Medication: List current medications.
Other Medical History: Detail any relevant medical history.
Examination: Detail all relevant findings - include specifically BP and heart sounds.
- 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.
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.