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.

  • sustained palpitations with any red flags:
    • chest pain
    • shortness of breath
    • syncope/pre-syncope (refer to Syncope and Pre-Syncope CPC)
    • persisting tachyarrhythmia on electrocardiogram (ECG)

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

Exclusions

Triage categories

Category 1 — appointment clinically indicated within 30 days

  • nil

Category 2 — appointment clinically indicated within 90 days

  • palpitations without red flags, but may include:
    • other cardiac symptoms
    • transient haemodynamic disturbance
    • abnormal electrocardiogram (ECG)
    • greater than 10% frequency of premature ventricular contractions (PVCs)

Category 3 — appointment clinically indicated within 365 days

  • PVCs with less than 10% frequency with red flag symptoms

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 frequency, duration and associated symptoms
  • alleviating factors
  • presence of red flags
  • history of underlying cardiac disease and risk factors
  • people identifying as Māori, Aboriginal and/or Torres Strait Islander - increased risk of acute rheumatic fever and rheumatic heart disease
  • familial history of sudden cardiac death, sudden infant death syndrome, or sudden unexplained death
  • urea, electrolytes, creatinine (UEC)
  • liver function tests (LFTs)
  • blood sugar levels
  • estimated glomerular filtration rate (eGFR)
  • thyroid stimulating hormone (TSH)
  • all available electrocardiograms (ECGs) during episodes if possible
  • holter monitor report

Additional information to assist triage categorisation

  • echocardiogram (Echo)
  • stress test
  • magnesium
  • use/frequency of alcohol, caffeine, 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.

Electrocardiogram (ECG) at the time of palpitation (even if normal) may be of highly relevant value.

Clinical resources

Consumer resources