Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • suspected acute coronary syndrome
  • suspected pulmonary embolism or aortic dissection
  • suspected or confirmed endocarditis, myocarditis or pericarditis
  • suspected ischaemic chest pain within 24 hours with any of the following red flags:
    • severe or ongoing chest pain
    • prolonged chest pain ≥ 10 minutes
    • chest pain at rest or with minimal exertion
    • chest pain associated with severe dyspnoea
    • chest pain associated with syncope/pre-syncope
    • respiratory rate ≥ 30 breaths per minute
    • tachycardia ≥ 120 beats per minute (BPM)
    • systolic blood pressure (BP) ≤ 90mmHg
    • heart failure (HF)/suspected pulmonary oedema
    • ST elevation or depression
    • complete heart block
    • new left bundle branch block
  • symptomatic atrial fibrillation (AF), supraventricular tachycardia (SVT), ventricular tachycardia (VT)
  • acute unstable angina/new onset angina
  • nocturnal angina

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network


Asymptomatic ischaemic heart disease more than 12 months since an acute cardiac event

Triage categories

Category 1 - appointment clinically indicated within 30 days

  • chest pain suggestive of angina
  • coronary artery disease (CAD) with recurrent symptoms, without red flags

Category 2 - appointment clinically indicated within 90 days

  • chronic suspected cardiac chest pain without red flags

Category 3 — appointment clinically indicated within 365 days

  • nil

For more on outpatient referrals, see the general referral information page.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • description of symptoms, frequency, duration and risk factors
  • presence of red flag symptoms
  • alleviating interventions and management
  • complete medical history
  • details of previous treatments and outcomes
  • current medication and previous therapies including risk factor management
  • known allergies and sensitivities
  • complete blood examination (CBE)
  • urea, electrolytes and creatinine (UEC)
  • liver function tests (LFTs)
  • blood sugar levels
  • estimated glomerular filtration rate (eGFR)
  • fasting lipids
  • glycated haemoglobin test (HbA1c)
  • electrocardiogram (ECG), specifically during episode/s of chest pain, and any other concerning tracings

Additional information to assist triage categorisation

  • relevant investigations and reports e.g., chest X-ray, cardiac imaging: stress test, stress echocardiogram (Echo) or myocardial perfusion scan (MPS)
  • Cardiovascular Risk Calculator
  • use/frequency of alcohol, tobacco and other drugs

Clinical management advice

Patients who have been seen by a specialist cardiologist previously, are encouraged to be referred back to their care for further review.

New symptom development on a background of previous angina/myocardial ischaemia/coronary artery disease (CAD) should be assessed promptly, and a referral back to previous treating cardiologist completed.

Patients with chronic stable angina or chest pain are advised to commence aggressive risk factor management with their General Practitioner.

Clinical resources

Consumer resources