What are the referral criteria for a patient with a newly detected heart murmur and associated symptoms such as dyspnea or chest pain?

Referral criteria for a patient with a newly detected heart murmur and associated symptoms such as dyspnea or chest pain:

• Offer an echocardiogram to adults with a murmur if valve disease is suspected based on the nature of the murmur, family history, age, or medical history, and they have symptoms such as breathlessness (dyspnea) or angina (chest pain), or signs like peripheral oedema, or an abnormal ECG.
• If valve disease is suspected and the patient has severe symptoms (angina or breathlessness on minimal exertion or at rest), offer urgent specialist assessment including echocardiography within 2 weeks.
• Adults with a systolic murmur and exertional syncope should also be offered urgent specialist assessment including echocardiography within 2 weeks.
• After echocardiography, refer to a specialist if moderate or severe valve disease is found, or if the patient has bicuspid aortic valve disease of any severity.

These criteria ensure timely diagnosis and management of potentially significant valve disease presenting with symptoms such as dyspnea or chest pain.

References: NICE NG208