Referrals
Chest pain (non-emergent) referral checklist
Non-emergent chest pain triage checklist with baseline investigations and referral notes.
Last reviewed 2026-01-05|cardio | chest-pain | triage
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Minimum pre-referral workup
- Detailed symptom history, risk factors, and cardiovascular exam.
- Resting ECG with interpretation.
- Recent vitals and blood pressure trends.
- Lipid profile and A1C if not up to date.
- Consider chest x-ray if respiratory symptoms present.
Urgency tier
- Ongoing chest pain at rest or escalating frequency.
- Syncope, severe dyspnea, or hemodynamic instability.
- New ischemic changes on ECG.
- Suspected acute coronary syndrome or elevated troponin.
- Signs of heart failure or aortic dissection.
Referral packet checklist
- Pain characteristics, triggers, and relief factors.
- Functional capacity and exercise tolerance.
- ECG findings and cardiovascular risk profile.
- Relevant labs and imaging.
- Current cardiac medications and comorbidities.
Pre-referral optimization tasks
- Confirm interim symptom-monitoring plan and medication adherence.
- Reinforce emergency activation instructions for recurrent rest pain or worsening dyspnea.
- Arrange short-interval follow-up while referral is pending.