Cardiology  |  Heart Failure Pathway - When to Consider a Referral


Heart Failure Pathway - When to Consider a Referral

Decide severity:

Grading is based on NYHA classification.

NYHA classification of dyspnoea

  • Class I - minimal symptoms
  • Class II - limiting symptoms with ordinary activity
  • Class III - limiting symptoms with minimal activity
  • Class IV - limiting symptoms at rest

Grade III-IV require referral

Grade II consider referral

These additional factors should influence referral and be included to assist in determining priority:

  • Age <65
  • Compromising  current occupation
  • Ability to live independently at risk
  • Suspected valvular or ischaemic heart disease.
  • CHF is the principle limiting factor vs.  significant  co-morbidities.
  • Cardiology expertise is required. (Remember Health in Ageing, Hospice etc can consult in a cardiology opinion).


Note: Some patients will be eligible for the nurse led heart failure clinic at the DHB. Inclusion at this clinic is at the discretion of the Cardiology team. If you feel your patient might be eligible, refer to Cardiology in the first instance. 

Last updated : Friday, August 21, 2015
Next review date : Saturday, August 20,2016

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.