Arnold et al listed recommended times for referral of a patient with heart failure. The authors are from multiple institutions in Canada.
< 24 hours
< 2 weeks
< 4 weeks
scheduled, priority (D)
< 6 weeks
scheduled, routine (E)
< 12 weeks
(1) New York Heart Association (NYHA) functional class
(2) AHA/ACC clinical stage
(3) heart failure factors
(4) critical conditions (acute severe myocarditis, acute pulmonary edema, evaluation for transplant or device placement)
new diagnosis, stable and compensated
post-hospital or ED visit
new diagnosis, unstable and decompensated
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Purpose: To determine the appropriate time interval for referring a patient with heart failure to a specialist.
Objective: severity, prognosis, stage, failure handling, when to refer, response to therapy