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PAGE 13 CARDIOLOGY National Referral Guidelines CORONARY ANGIOGRAPHY • Angina not adequately controlled by medical treatment, or medical treatment not tolerated. • Angina or ischaemia early post-myocardial infarction • Angina/non Q wave myocardial infarction associated with myocardial necrosis (elevated troponin T or I) or intermittent ST/T changes. • Myocardial ischaemia on the treadmill within 9 minutes (stage I to III) of the Bruce protocol (or equivalent by stress echocardiography, nuclear perfusion) • Patients >40 years or at risk for coronary disease undergoing valve or other non-coronary cardiac surgery. • Unexplained “cardiomyopathy”, ventricular arrhythmias or cardiac arrest. • Congestive heart failure with regional left ventricular wall motion abnormalities • Episodic congestive heart failure and normal or near normal left ventricular systolic function. • Myocardial ischaemia precluding occupational licensing. • Chest pain - uncertain diagnosis after non-invasive assessment. • Acute myocardial infarction - cardiogenic shock, alternative to thrombolysis, clinically failed reperfusion with thrombolysis National Referral Guidelines CORONARY ANGIOPLASTY • Clinical indication as for coronary angiography And • Coronary anatomy suitable for percutaneous intervention Version 1 Cardiology Referral Guidelines and Priorisation Criteria • Date: 9/4/2000 • Authorised: Elective Services, HFA
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