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Referrals to the rapid access chest pain clinic

The purpose of this clinic is to identify patients with new onset of chest discomfort, suggestive of angina, who may benefit from urgent investigation and treatment. Consequently, referral criteria are set with this in mind.

All referrals should be made through the chose and book system and are triaged by the cardiology team, either a consultant cardiologist or specialist nurse who will determine the need for further assessment.

Referral form

Indications

Patients who are over 30 years old* with:

  • Recent-onset (within 6 months) of exertional chest discomfort suggesting new diagnosis of ischaemic heart disease (IHD)
  • Recurrent/worsening symptoms in a known IHD patient who is not under follow-up by a cardiologist

*patients under the age of 30 can be referred where there is a strong history suggestive of cardiac ischaemia defined as having all of the following features:

  • Exertional chest discomfort
  • AND symptoms provoked by walking or other cardiovascular exercise
  • AND symptoms relieved by rest or GTN

Exclusions

Patients who:

  • Are under current cardiology review (please refer to current cardiologist)
  • Have had normal myocardial perfusion scan, stress echo, CT coronary angiogram or coronary angiogram within the last three years. (if there is a strong suggestion of angina, despite the test result, refer to consultant cardiologist through choose and book).
  • Complain of a single episode of chest pain lasting less than 20 minutes

Refer to a consultant cardiologist if the patient has:

  • A new murmur or ECG changes in the absence of cardiac symptoms.
  • Longstanding symptoms which require assessment in the context of a complex cardiac history
Referrals made to the clinic should include an ECG and blood tests (Full blood count, blood glucose or HbA1C, lipid profile, renal, liver and thyroid function). This is essential information which will be used to triage, assess and manage the patient when seen in the clinic. Please do not delay referral whilst waiting for blood test results.