Cardiology specialty
| Category A | Category B | Category C |
|---|---|---|
| Local hospital planned care Refer to MDT for opinion if required | Consider referral to MDT for discussion and advice | Refer to MDT Consider transfer of Care |
| Congenital heart disease | ||
| • Successfully repaired or device closed ASD/VSD/PDA/partial or total anomalous pulmonary venous connection with no arrhythmia or LV/RV dysfunction • Repaired AVSD with no or mild left AV valve regurgitation | • Tetralogy of Fallot • Successfully repaired or stented coarctation • AVSD with residual moderate or greater left AV valve regurgitation | • Unrepaired ASD/VSD/PDA • Systemic right ventricle • Fontan circulation • Cyanotic heart disease • Unrepaired coarctation or severe recoarctation • Other complex congenital heart disease |
| Arrhythmias and channelopathies | ||
| • SVT • Successfully ablated atrial arrhythmias | • Arrhythmias that are problematic or requiring 2 or more agents • Channelopathies including Brugada syndrome, Long QT syndrome, CPVT and other ion channel diseases linked to heart rhythm disturbance | • Poorly controlled ventricular arrhythmias |
| Aortic disease | ||
| • Marfan syndrome with normal aorta • Bicuspid AV with Aorta <45 mm • Previous aortic dissection • Turner Syndrome (irrespective of aortic dimensions) | • Marfan syndrome with dilated aorta • Loeys-Dietz syndrome, Takayasu’s Disese (irrespective of aortic dimensions) • Turner’s syndrome with aortic dimensions) • Aorta >45 mm in association with bicuspid aortic valve • Vascular Ehlers-Danlos Syndrome (all patients) |
|
| Valvular heart disease | ||
| • Mild to moderate AS/AR, MR, PS/PR with no evidence of LV/RV dysfunction • Mild mitral stenosis with no current atrial arrhythmia | • Any bioprosthetic valve • MR severe or with evidence of LV • PS/PR severe or with evidence of RV dysfunction | • Any mechanical valve • AS/AR – moderate or severe or with evidence of LV dysfunction • Mitral stenosis |
| Myocardial disease | ||
| • Left ventricular impairment that is mild and stable but with a low threshold for MDT referra | • Cardiomyopathies including hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, left ventricular non-compaction and other inherited disorders of heart muscle • Left ventricular impairment of any cause that is moderate • Previous or current peripartum cardiomyopathy (including if LV function normal after previous peripartum cardiomyopathy) | • Left ventricular impairment of any cause that is moderate-severe or severe • Cardiomyopathies with significant adverse features e.g. severe LVOT obstruction with HCM, poor RV function or ventricular arrhythmia with ARVC |
| Coronary disease | ||
| • Previous myocardial infarction related to acquired coronary disease (NSTEMI or STEMI) • Previous myocardial infarction related to spontaneous coronary artery dissection • Previous myocardial infarction related to thrombotic coronary artery occlusion (paradoxical embolus, thrombus in situ) | ||
| Pace makers and defibrillators | ||
| • Normally functioning devices with sufficient battery longevity to complete pregnancy | • Active device complications including lead malfunction, system infection, insufficient battery longevity to complete pregnancy • Appropriate and inappropriate therapy for ventricular tachycardia | • Device related complications that require tertiary cardiology care |
| Other | ||
| • Pulmonary Hypertension • Heart Transplant |