title: A single-center prospective study analyzing the cardiac referrals made to a tertiary care center in India.
abstract: BACKGROUND
  Healthcare system in most parts of the world functions on a three-tier system, involving primary, secondary, and tertiary care centers. The appropriate and efficient referral system plays crucial role in maximally efficient healthcare delivery.
  
  
  METHODS
  In all, 46 referrals made to the medicine department of the hospital over a period of 1 month with chief complaint of chest pain and presumptive diagnosis of myocardial ischemia/infarct by outside physicians were selected randomly. Analysis was done both for extent and clarity of useful information provided.
  
  
  RESULTS
  Out of 46 referrals, exact indication for referral was mentioned in 4 (8.7%), time of referral in 2 (4.3%), blood pressure in 38 (17.4%), pulse rate in 29 (63.04%), respiratory rate in 1 (2.17%), electrocardiograph diagnosis was not mentioned in 12 (26.08%), and the contact number/details of referring physician were mentioned in 2 (4.34%). Correct dose of aspirin was given to 27 (58.69%), clopidogrel to 19 (41.30%), statins to 9 (19.45%), angiotensin-converting enzyme inhibitors to 6 (13.04%), beta-blockers to 8 (17.39%), low-molecular weight heparin in 6 (13.04%), and 22 (47.82%) patients warranted thrombolysis, but was given in 12 (54.54%).
  
  
  CONCLUSIONS
  There is a serious lack of quality and clarity of important information provided while making referrals.
authors.affiliation: Department of Medicine, University College of Medical Sciences (University of Delhi) and GTB Hospital, New Delhi.
authors.forename: Sourabh
authors.initials: S
authors.lastname: Aggarwal
authors.forename: Alka
authors.initials: A
authors.lastname: Sharma
authors.forename: Vishal
authors.initials: V
authors.lastname: Sharma