Cardiac Centre Clinics |
B59
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Rapid Access Chest Pain Clinic
Rapid Access Chest Pain
Please refer via eRS, using the above referral form.
Appointments are made by RUH Appointments Centre.
This chest pain clinic is for patients who are felt to have a high suspicion of symptomatic, obstructive coronary artery disease.
Defined by NICE as:
A. Typical angina? (3 out of 3)
- Constricting discomfort in chest/neck/shoulder/jaw
- Precipitated by physical exertion
- Relieved with rest or GTN
B. Atypical angina? (2 out of 3)
- Constricting discomfort in chest/neck/shoulder/jaw
- Precipitated by physical exertion
- Relieved with rest or GTN
C. Non-anginal chest pain with Q waves/ST changes? (0 or 1 out of 3)
- Constricting discomfort in chest/neck/shoulder/jaw
- Precipitated by physical exertion
- Relieved with rest or GTN
If your patient does not fall into one of the above categories e.g. non angina chest pain or/and no ECG changes, please exclude other causes of chest pain. If the primary symptoms is not chest pain - i.e. palpitations/shortness of breath - please refer to an alternative cardiology clinic.
Patients with acute chest pain or unstable symptoms, which are suggestive of acute coronary syndrome (ACS) should be referred to the Emergency Department.
Preparation
Please do in advance:
- Full blood count
- Random glucose and cholesterol
- TSH
- U&E
- Calculate BMI
- 12-lead ECG
- Patients WILL need rate limiting medications prescribed, as per referral form
- Listen to heart sounds- if high clinical suspicion of severe Aortic Stenosis (AS), please ensure patient referred for urgent Echo and cardiology outpatient review.
- If high suspicion of coronary disease, secondary prevention medications should be considered.
Please note we cannot refer patients direct to CT coronary angiogram if suspicion of severe AS due to use of GTN.
ECG Advice service
A service allowing advice on any difficult/ atypical ECG's you may encounter during General Practice Consultations, can be reviewed via Cinapsis.
Any subsequent referral will need to be made via eRS.