Murmurs

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to the Referral Standards and must include:

  • Physical findings including colour assessment or oxygen saturation
  • Report presence or absence of the following:

- History of exercise intolerance

- Cyanotic episodes or blue spells

- Weak or absent femoral pulses

- Clubbing

Highly desirable information - may change triage category

  • Known other congenital abnormalities
  • Family history of congenital cardiac disease
  • Aboriginal or Torres Strait Islander or Maori status (acute rheumatic fever / rheumatic heart disease risk)

Tests

  • CXR
  • ECG

Interim/GP management

To refer a patient with this condition, please see the Cardiology clinic page for the full referral process and templates.

Desirable information - will assist at consultation

  • Other past medical history
  • Immunisation history
  • Developmental history
  • Medication history
  • Significant psychosocial risk factors (especially parent’s mental health, family violence, housing and financial stress, department of child safety involvement).
  • Height/weight/head circumference and growth charts with prior measurements if available.
  • Other physical examination findings inclusive of CNS, birth marks or dysmorphology.
  • Any relevant laboratory results or medical imaging reports, urinalysis result.

Interim management advice for Heart Murmurs in Adults can be found on the Health Pathways website.

For more information please see the Tasmanian Health Pathways website.

Emergency

Suspected or confirmed Bacterial Endocarditis

Patients in decompensated heart failure

Urgent / category 1

Asymptomatic murmur in a baby from birth to 3 months

  • Asymptomatic murmur at any age in association with acute rheumatic fever
  • Murmur with cyanosis, heart failure, syncope or seizures
  • Children already diagnosed with a condition with known cyanosis or heart failure

Semi-urgent / category 2

  • Asymptomatic murmur in a child aged 4 months to 2 years
  • Murmur at any age with a past history of rheumatic fever

Routine / category 3

  • Asymptomatic murmur in a child over 2 years old

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH
ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within one week, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within four weeks

Routine:

Next available appointment usually within eight weeks