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Use our "Virtual Information Desk", accessible at the top of any page on our website by clicking on this Visitor Information Panel icon icon, to help answer common questions or help you find your way before and during your hospital visit.

Of course, you can visit our onsite main Information Desk located at the Melnyk Entrance (off of the Queensway) which is open from 7am to 9pm, Monday to Friday, and from 9am to 9pm Weekends and Holidays. Feel free to call us at 416-530-6000.

Find us at St. Joes
St. Joseph's Health Centre Toronto

Cardiology

Cardiology-banner

One of the most common diseases affecting people across our country is heart disease. At St. Joseph’s Health Centre, our experienced team of cardiologists and cardiac diagnostic technicians provide people living in West Toronto with the best heart care when they need us the most. Keeping your heart healthy and strong is our number one priority.

Our cardiologists diagnose and manage a wide range of cardiovascular diseases including:

  • Coronary artery disease
  • Heart rhythm problems (arrhythmias)
  • Heart valve problems
  • Heart failure

We specialize in a number of cardiology fields including:

Our outpatient services include diagnostic tests like electrocardiograms (ECGs), echocardiograms (ultrasound of the heart), stress tests and many more. Please read the section “Preparing for your visit” to see a full list of tests we offer, what they are and what you can expect when you arrive for your appointment.

An appointment is required for all tests with the exception of an ECG (walk in from Monday to Friday 7:30 a.m. to 3:30 p.m.). To make an appointment for a test or to see a cardiologist, a referral is required from a physician or nurse practitioner. Please read the section “How to refer a patient” for referral information.

For additional information please visit:

What to bring to your appointment

If you are coming for a test or an appointment with your doctor, please bring your health card and your St. Joe’s hospital card if you have one.

If you are seeing a cardiologist or having a stress test, please bring all of your medications, a list of your medical concerns that you want to discuss and any other health records that may be helpful.

The types of tests you may have during your visit:

Echocardiogram (ECHO)

Preparation required: none
Time required for this test: about 40 minutes

  • An echocardiogram or “ECHO” is an ultrasound of your heart (similar to other medical ultrasounds including those conducted on pregnant women and those to look at organs). It provides detailed information about the heart’s structure and function – including the pumping function of the heart as well as the function of the valves in the heart. The technology makes use of sound waves to create images and therefore does not involve any radiation exposure.
  • Normally the echocardiogram is performed through the chest wall – this is called a transthoracic ECHO. Occasionally when more detailed information is required, the ECHO probe may be passed down the esophagus (the swallowing tube, which sits just behind the heart) – this is called a transesophageal ECHO.
  • Sometimes contrast is required so we can see the heart. This involves inserting an intravenous and injecting a small amount of a contrast liquid.

Transesophageal Echocardiogram (TEE)

Preparation required: nothing to eat for at least eight hours before the test
Time required for this test: about two hours, however, the test itself only lasts about ten to 30 minutes. The rest of the time is spent preparing for the test and monitoring you after.

  • A transesophageal echocardiogram, or TEE, is a specialized type of heart ultrasound, where instead of the ultrasound being placed on the chest wall, it is put down the esophagus (the swallowing tube).
  • Because the heart sits right in front of the esophagus, very detailed information about the heart can be obtained during this test.
  • A TEE is sometimes requested so we can clearly see a heart valve to confirm there’s no infection on the heart valve or blood clot in the heart.
  • A TEE is a day procedure.
  • An intravenous will be inserted and you will be given a medication to relax you but not completely put you to sleep. A medication will also be sprayed at the back of your mouth to numb it.

Electrocardiogram (ECG)

Preparation required: none
Time required for this test: about ten minutes

  • An electrocardiogram, “ECG” or “EKG” is a tracing of the electrical activity of the heart. It is a non-invasive test and involves applying ten stickers to your chest, arms and legs.
  • From the ECG, the rhythm of the heart can be determined. Normal rhythm is called sinus (originating from the sinus node). Other abnormal rhythms that can be identified by the ECG include atrial fibrillation and forms of heart block.
  • An ECG may also provide clues that a chamber in the heart is enlarged and can sometimes show evidence of a previous heart attack.

Holter monitor

Preparation required: none
Time required for this test: about ten minutes to set up and then you will drop off the monitor in one or two days, depending on how long your doctor has asked for your heart to be monitored.

  • A holter monitor is a device that is used to look at your heart’s rhythm and detect fast or slow heart rhythms. It may be ordered if you complain of palpitations or if you feel dizzy or lightheaded.
  • A holter monitor can be requested for 24 or 48 hours. You will come in to hospital to have the holter connected, which involves placing stickers on your chest and connecting wires to a small that box that you will carry around with you for the duration of the test. You will then go home and return the monitor after a day or two.
  • While you are wearing the monitor, it is important to take note of your symptoms. You will be given a diary and if you have your typical symptoms (palpitations, dizziness, etc.) you should mark them in the diary. This will allow the technologist to go back and see if there was any abnormal heart rhythm correlating with those symptoms.

Loop recorder

Preparation required: none
Time required for this test: about ten minutes to set up and you will drop off the monitor in two weeks.

  • This is a test similar to a holter monitor (see that test description for more information), except that it can be worn for much longer – up to two or four weeks.
  • It is a test to look at the heart rhythm and to try to detect abnormal fast or slow heart rhythms.
  • Similar to a holter monitor, you will have stickers applied to your chest, attached by wires to a monitor.

Ambulatory Blood Pressure Monitor (ABPM)

Preparation required: none
Time required for this test: about ten minutes to set up and then you will drop off the monitor after one day

  • This is a blood pressure monitor that you wear to take your blood pressure periodically throughout the day.
  • In some people, their blood pressure is high only when they come in to hospital or when they see their doctors. This is called white coat hypertension. An ABPM may be helpful to diagnose this condition. It can also be used to see how well a person’s blood pressure is controlled on medications.

Exercise stress test

Preparation required: none
Time required for this test: about 45 minutes. The actual duration of exercise will be about ten to 15 minutes.

  • An exercise stress test may be performed for a number of reasons, but it is usually requested to determine a person’s risk of having coronary artery disease (cholesterol plaque causing blockages in the arteries around the heart).
  • The test involves placing stickers on your chest and limbs to allow for continuous monitoring of the electrical activity of the heart. Your blood pressure is also checked every few minutes.
  • You will exercise for as long as you can, usually on a treadmill. The treadmill increases in speed and incline every few minutes. There is no set length for the stress test.
  • In order to obtain the most information from the stress test, there is usually a target heart rate set, which is based on your age.

Nuclear stress test

Preparation required: No caffeine (coffee, tea, chocolate, decaffeinated pop, coffee, tea, etc.) for 12 hours before the test. Your doctor may also recommend that you do not take certain medications before the test but please be sure to discuss this with them.
Time required for this test: about four hours

  • A nuclear perfusion scan is a special type of stress test that uses a small dose of an intravenous radioactive material to look at the blood flow to the heart. Pictures of the heart are taken at rest and then after stress. If there is reduced uptake of the radioactive tracer in a certain part of the heart, this may suggest that there is a narrowed or blocked artery supplying that territory of heart muscle.
  • There are two ways to test stress on your heart. We prefer to use exercise, similar to a treadmill stress test. However, if you are not able to exercise, then a drug can be used to stress the heart (pharmacologic stress).
  • A nuclear perfusion scan is more sensitive than a plain exercise stress test at detecting coronary artery disease and determining the extent of disease.

Multi-gated Acquisition (MUGA) scan

Preparation required: none
Time required for this test: about onehour

  • A MUGA scan is a non-invasive test. It is a nuclear medicine test which involves the injection of a small amount of a radioactive tracer. After the radioactive tracer is injected, several pictures of your heart will be taken using a special camera.
  • The purpose of a MUGA scan is to get a very accurate assessment of the left ventricular ejection fraction.

Physicians or nurse practitioners can fax patient referrals to the Cardiology department at 416-530-6702. Please use this fax number for all cardiac tests, consultations and urgent requests for chest pain evaluations.

Physicians referring a patient for a cardiac test or consultation can complete the requisition form and fax it to our department.

Requests for cardiology consultations should be faxed to us with all relevant information included.

Urgent requests for chest pain evaluation (including consultations and stress tests) can be faxed directly to our department.

Referral request form

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