Cardiology

Triage criteria and referral process for physicians

General Cardiology

Emergent
Criteria (not all inclusive)
  • Acute or suspected MI
  • Unstable angina with chest pain
  • Acute heart failure
  • SBE actual/suspected
  • Suspected aortic dissection
  • Suspected cardiac tamponade
Process

1) PHONE 902-473-2220 "Triage Cardiologist"

Urgent
Criteria (not all inclusive)
  • Crescendo angina
  • Symptomatic aortic stenosis
  • Multiple syncopal episodes
  • Syncopal episodes with known structural heart disease or abnormal ECG
  • Symptomatic valvular disease other than aortic stenosis (> FC II)
  • Newly diagnosed heart failure or known heart failure with deterioration
  • Cardiac disease in pregnancy
Process

1) PHONE 902-473-2220 "Triage Cardiologist"
2) FAX referral - attach EKG and recent blood work or other relevant tests

Semi-Urgent
Criteria (not all inclusive)
  • Recent onset but stable angina
  • Recent onset atrial fibrillation
  • Suspected cardiac source of an embolus
  • Patients needing cardiac assessment for semi-urgent non cardiac surgery – refer to General Internal Medicine (GIM)
Process

1) FAX referral - attach EKG and recent blood work or other relevant tests

Non-Urgent
Criteria (not all inclusive)
  • Stable angina
  • Chest pain for diagnosis - low probability of IHD
  • Shortness of breath / Cardiac basis
  • Chronic atrial fibrillation
  • A person whose employment status is threatened
  • Asymptomatic patients with ECG changes
  • Asymptomatic valvular disease
  • Hyperlipidemia
  • Reassessment of stable patients requiring review of current treatment where appropriate
  • Asymptomatic murmur (please use referral form for family physicians to order echo)
  • Palpitations without syncope – refer to GIM
  • Cardiac risk reduction – refer to GIM
Process

1) FAX referral - attach EKG and recent blood work or other relevant tests

 

Arrhythmia / Electrophysiology *

*In most cases, these patients will be under specialist care. Electrophysiology referrals should come from an internist or general cardiologist.
Emergent
Criteria (not all inclusive)
  • Hemodynamically significant arrhythmias

Process
1) 
PHONE 902-473-2220 "Triage Cardiologist" OR electrophysiologist of choice

Urgent
Criteria (not all inclusive)
  • Resuscitated cardiac arrest, arrhythmia with severe symptoms

Process
1) PHONE 902-473-2220 "Triage Cardiologist" OR electrophysiologist of choice
2) FAX referral form with relevant clinical tests to specific physician and indicate willingness to redirect to first available if desired.

Semi-Urgent
Criteria (not all inclusive)
  • Patients with syncope and structural heart disease
    (e.g. Ejection fracture less than 40%, bundle branch block, hypertrophic cardiomyopathy, congenital heart disease, family history of sudden cardiac death or inherited heart disease) or primary arrhythmic conditions that could be associated with a risk of significant morbidity or mortality
  • Patients referred for consideration of implantable cardioverter defibrillator (primary prevention) and/or a cardiac resynchronization therapy device

Process
1) 
FAX referral form to electrophysiologist of choice

Non-Urgent
Criteria (not all inclusive)
  • Patients electively referred for an electrophysiologist’s opinion (e.g. supraventricular tachycardia, syncope without structural heart disease or other medical conditions)

Process
1) 
FAX referral form to electrophysiologist of choice

 

Cardiac Rehab Program

Non-Urgent
Criteria (not all inclusive)
  • Meets high risk stratification criteria
  • Clinical depression
  • Non-revascularization cardiac disease
  • Significant anxiety
  • Financial hardship (e.g. return to work commitments)

Process
Patients are automatically referred to Program upon discharge from Cardiology inpatient units or by referral from family physician/specialist or by referral from Health Professionals directly involved with patients.
1) Call 902-473-3846 to request referral form;
2) Fax referral form 902-473-7855 or mail to:

Cardiovascular & Pulmonary Health in Motion
Nova Scotia Rehab Centre, Room 623
1341 Summer Street, Halifax, NS  B3H 4K4

 

Contact information and forms

Fax 902-425-3768 (general fax number – see link below for cardiologist of choice)
Cardiologists View list of physicians
Forms

* Can complete electronically, print and fax to applicable number

 

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View the Division of Cardiology