{"id":13833,"date":"2023-02-14T09:49:07","date_gmt":"2023-02-14T09:49:07","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=13833"},"modified":"2024-12-18T12:43:05","modified_gmt":"2024-12-18T12:43:05","slug":"cardiac-investigations-for-breathless-patients","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/cardiology\/cardiac-investigations-for-breathless-patients\/","title":{"rendered":"Cardiac Investigations for Breathless Patients"},"content":{"rendered":"\n<p><strong>Breathlessness<\/strong><\/p>\n\n\n\n<p>The majority of patients with breathlessness do not have an underlying cardiac cause.&nbsp; 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.&nbsp; Please see \u201c<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/heartfailure\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/heartfailure\/\" target=\"_blank\" rel=\"noreferrer noopener\">Heart Failure<\/a>\u201d section for eligibility and referral criteria. <\/p>\n\n\n\n<p><strong>Other symptoms including patients with persistent post-COVID symptoms<\/strong><\/p>\n\n\n\n<p><strong>Note that information regarding respiratory symptoms post-COVID can be found on the <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/postcovidbreathlessness\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/postcovidbreathlessness\/\" target=\"_blank\" rel=\"noreferrer noopener\">COVID-19 Post Covid Breathlessness <\/a>Refhelp page.<\/strong><\/p>\n\n\n\n<p>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 <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/referrals-for-echocardiography\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/referrals-for-echocardiography\/\" target=\"_blank\" rel=\"noreferrer noopener\">referrals for echocardiography<\/a>). <\/p>\n\n\n\n<p>Patients with persistent tachycardia can be requested to have ambulatory monitoring (see <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/directaccessambulatoryecgmonitoring\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/directaccessambulatoryecgmonitoring\/\" target=\"_blank\" rel=\"noreferrer noopener\">Direct Access Ambulatory ECG<\/a>).<\/p>\n\n\n\n<p>If the echocardiogram or Holter monitor show abnormalities, patients can then be referred to General Cardiology.<\/p>\n\n\n\n<p><strong>C.W &amp; C.S 14-02-23<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\"><strong>Who to refer:<\/strong><\/h4>\n\n\n\n<p>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.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who not to refer:<\/strong><\/h4>\n\n\n\n<p>Patients with breathlessness whose clinical features do not suggest a cardiac cause<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>How to refer:<\/strong><\/h4>\n\n\n\n<p>See above for information regarding where to direct your referral and how to refer.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a href=\"https:\/\/www.chss.org.uk\/chest-information-and-support\/living-with-your-chest-condition\/breathlessness\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.chss.org.uk\/chest-information-and-support\/living-with-your-chest-condition\/breathlessness\/<\/a><\/p>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Breathlessness The majority of patients with breathlessness do not have an underlying cardiac cause.&nbsp; 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.&nbsp; Please see &ldquo;Heart Failure&rdquo; section for eligibility and referral criteria. Other symptoms including patients with persistent post-COVID<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":3769,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[883,58],"class_list":["post-13833","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-cardiac-investigations-for-breathless-patients","category-cardiology"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/cardiology\/https-apps-nhslothian-scot-refhelp-cardiac-investigations-for-breathless-patients\/\" rel=\"tag\">Cardiac Investigations for Breathless Patients<\/a><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/cardiology\/\" rel=\"tag\">Cardiology<\/a>","rttpg_excerpt":"Breathlessness The majority of patients with breathlessness do not have an underlying cardiac cause.&nbsp; 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.&nbsp; Please see &ldquo;Heart Failure&rdquo; section for eligibility and referral criteria. Other symptoms including patients with persistent post-COVID","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/13833","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=13833"}],"version-history":[{"count":6,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/13833\/revisions"}],"predecessor-version":[{"id":16407,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/13833\/revisions\/16407"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3769"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=13833"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=13833"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}