Breathlessness
The majority of patients with breathlessness do not have an underlying cardiac cause. However, presence of an abnormal ECG, cardiomegaly, audible cardiac murmur or clinical/radiological evidence of cardiac failure increases the likelihood for a heart failure diagnosis. Please see “Heart Failure” section for eligibility and referral criteria.
Other symptoms including patients with persistent post-COVID symptoms
Note that information regarding respiratory symptoms post-COVID can be found on the COVID-19 Post Covid Breathlessness Refhelp page.
Patients with breathlessness, tachycardia, or reduced exercise intolerance can be referred for a 12 lead ECG initially. If this is abnormal an echocardiogram can be requested directly, (see referrals for echocardiography).
Patients with persistent tachycardia can be requested to have ambulatory monitoring (see Direct Access Ambulatory ECG).
If the echocardiogram or Holter monitor show abnormalities, patients can then be referred to General Cardiology.
C.W & C.S 14-02-23
Who to refer:
Patients where a cardiac cause is suspected due to clinical features (abnormal ECG, cardiomegaly, audible cardiac murmur or clinical/radiological evidence of cardiac failure) or where the diagnosis remains unclear and there is a high clinical index of suspicion for underlying cardiac cause.
Who not to refer:
Patients with breathlessness whose clinical features do not suggest a cardiac cause
How to refer:
See above for information regarding where to direct your referral and how to refer.
