Echo referral

Please include in the clinical details all the data which would be sent for a  referral to the cardiology clinic:

• History and examination findings
• FBC, U&E
• ECG

Referrals are done via SCI Gateway...DGRI...Cardiology...Open Access Echo

Appropriate patients for referral would include those with :-

• New Murmurs - do check back records to ensure this has not previously been diagnosed. 
• New onset AF with heart murmur 

Referrals for diagnosis of heart failure should be referred via the heart failure pathway.

For other possible indications discuss first with cardiologist via SCI Gateway advice request.

Referrals will be triaged by a clinical physiologist.

Echo reports will be discussed with a cardiologist if significant findings are identified and advice included with report or a cardiology review will be arranged as appropriate. Otherwise, the report will be returned to the referrer with a clear interpretation.

Any patients who you feel need urgent echo should be discussed with the on-call cardiologist.

Patients with suspected heart failure should not be referred via the 'Open access echo' pathway. Instead refer via the Heart Failure pathway.

Echo is generally not indicated for:

• Asymptomatic patients with known innocent murmur
• Patients in which the diagnosis of a murmur will not change their management or outcome
• Routine assessment of patients with hypertension
• Vasovagal syncope with clear precipitant and normal ECG
• Palpitations not confirmed on ECG

Refer to cardiology for advice rather than direct echo referral for:

• First-degree relatives of patients with potentially inherited cardiac conditions
• Isolated left ventricular hypertrophy on ECG with no symptoms and normal cardiac examination
• New onset AF where there is query about valvular cause or if cardioversion is to be considered.