Cardiology Clinic

About the Cardiology Clinic

The Department of Cardiology provides a complete range of diagnostic and treatment services including fetal cardiology consultations, testing and follow-up appointments. Learn more about the services and support we offer below.

Location and hours

Clinic C-18, Third floor, Room 3302

Cardiology (C-18), CHEO
401 Smyth Road
Ottawa, ON K1H 8L1

Clinic Hours are 8:00 a.m. to 4:00 p.m. Monday to Friday (except holidays).

Requesting and preparing for your appointment

To make an appointment with a cardiologist, your pediatrician, family physician or another physician-specialist must refer you. All referrals are reviewed and appointments are scheduled based on the urgency of the case.

If this is an urgent referral requiring an assessment in less than 48 hours, the referring physician must call CHEO’s main number (613-737-7600) and page the Cardiologist on service.

Make a referral

How does the referral process work?

The referring physician provides information about the patient to the Cardiology Department. This information is then reviewed and used to decide the appropriate time to be seen by a Cardiologist. Because of this, the Division of Cardiology cannot guarantee an appointment within a specific period of time. Patients are notified directly either by phone or by mail of their appointment time. If no one is at home at the time of the call, a message is left to call the Cardiology Department to confirm the appointment.

Cardiology will contact the referring physician if there are special instructions for the family and patient regarding their visit.

Make a referral

Cardiology Clinic referral form

Please have your physician fill out the referral form and mail or fax it to:

Division of Cardiology, CHEO
401 Smyth Road
Ottawa, ON K1H 8L1
Fax: 613-738-4835

Please include with your referral:

any relevant test results
any relevant discharge summaries or reports
relevant family history
other relevant medical history
list of current medications
allergy information

Please indicate on the referral if an interpreter is required and for which language if not English or French.
It is the referring physician's responsibility to notify the Cardiology Department if the status of the patient changes.

It is the referring physician’s responsibility to notify the patient and family of their referral to CHEO.

Referral criteria for specialized testing

Download the cardiology Clinic Referral Form and have your physician fill it out and send to us.

Echocardiograms (ECHO's) are provided on a limited basis without prior cardiac consultation. Generally, this is appropriate when a specific diagnosis is being considered i.e. Marfan’s Syndrome.

ECG’s are available upon request by physician referral.

Bring the following with you to your appointment:

health card
any medications

About your appointment

What should I bring for my clinic appointment?

Your child's health card
All medications your child is prescribed. Please bring these to each of your appointments. The nurse will ask if you need a prescription refill for your child's medication. That is why it is important to bring all medications to the appointment with you.
Any allergy information your child has to medications or food.

NOTE: If your child requires antibiotics prior to procedures i.e dental surgery because of his or her heart problem, the cardiologist or the nurse will inform you. Written information is given to you, which reviews indications for antibiotic use. The dentist or family physician prescribes the antibiotics for your child.

What can my child bring from home?

A bottle or soother is helpful for an infant. We do offer video or DVD movies as a distraction in the reception area and for echocardiogram testing only. We encourage you to bring along a favorite toy, blanket, storybook or movie to help your child remain relaxed.

What to bring to my exercise test?

Bring shorts/jogging pants, running shoes and a bottle of water with you.

Do not have a heavy meal within 2 hours before the test but do have a snack 1 hour before e.g.: soup, juice, fruit or granola bar.

Cardiology clinics and programs

Pediatric Cardiology clinic

A visit to the clinic will begin with an initial assessment by one of the cardiology nurses. Because CHEO is a teaching hospital affiliated with the University of Ottawa Faculty of Medicine, your visit may also include an initial assessment by a senior medical student or pediatric resident (a doctor who is doing special training to become a pediatric doctor) prior to seeing the cardiologist. Depending upon what tests are required, your visit may take up to two hours. Most new patients will not require any testing on their initial visit.

Arrhythmia clinic

In the CHEO Arrhythmia Clinic, we care for children and youth who have problems with their heart rhythm (or heart beat). We also care for children who are at risk for heart rhythm problems. Some of these problems run in families, so we use the specific expertise to carefully assess children and teenagers to see if they also have the condition.

Pacemaker clinic

The Pacemaker Clinic is scheduled several times a month for routine follow-up. Previously seen patients and their families can call the Nursing Line (613-737-7600 ext. 3109) with questions concerning the child’s pacemaker or other health issues.

When your child’s heart needs a pacemaker, it is inserted to relieve symptoms of heart rhythm disturbances. It does this by restoring normal heart rates. Regular follow-up clinic visits ensure the pacemaker is working properly.

During your child’s visit, a small computer is used to read information inside the pacemaker. The first step is to apply 5 stickers attached to 5 leads (insulated wires), which connect with the small computer. Then, a special pacemaker magnet is placed on the skin over your child’s pacemaker. Many parts of the pacemaker are checked during these visits including the pacemaker settings, the battery status and the leads.

Many of the pacemaker’s functions can be adjusted or programmed by the pacemaker doctor or nurse to meet your child’s needs and to help the system last as long as possible.

During this appointment you may also be scheduled for an ECG and/or Holter. X–rays are also routinely requested at this time.

Satellite and outreach clinics

The Cardiology Department performs outreach clinics to Iqualuit, Baffin Island once to twice a year. Children with suspected and known heart disease from the communities of Nunavut can receive full cardiac evaluations during these clinics, often saving them a more extensive trip to Ottawa.

Fearless physical activity

The Canadian Congenital Heart Alliance is proud to present the Fearless Physical Activity event series to Ontarians living with congenital heart disease. Fearless Physical Activity is designed to provide you and your family the opportunity to try fun physical activities available in your local community. Each season, multiple Fearless Physical Activity events will be held across the province. Come learn about fun ways to integrate physical activity into your lifestyle!

Maple Minds

Maple Minds is a mindfulness, yoga and relaxation group program to help manage chronic disease. Learn more about our Maple Minds Program and how it can help your family.

Summer Camp

The 2019 summer camp approved for cardiac kids, running from August 12th to August 16th, is a great opportunity for kids with various cardiac conditions to have fun, experience camp life, meet new friends, and make wonderful memories, all while in a safe environment. This 1-week day camp will be filled with activities such as canoeing, climbing wall, swimming, high ropes course, crafts and outdoor group activities, all adaptable according to the child’s health. An open-door day, for the whole family, will take place on May 26th, 2019. You’ll be able to learn more about the opportunity as well as meet other families. For more information and/or to register, please contact Angelica Blais by email at ablais@cheo.on.ca.

About the team

The Department of Cardiology is made up of six full time pediatric cardiologists and a team of health care professionals. Our team includes social workers, technologists and more. During your visit, you may meet:

Pediatric cardiologist

A specialized pediatric physician who is able to diagnose and treat the heart malformation in your child. CHEO’s pediatric cardiologists have specialized training in interventional catheterization, echocardiography, fetal echocardiography, electrophysiology, and diagnostic imaging including MRI’s.

Pediatric cardiovascular surgeon

A surgeon specialized in performing pediatric cardiac surgery.

Cardiology fellow

A physician who is in the process of obtaining his or her specialization in pediatric cardiology medicine.

Medical resident

A resident who provides care for patients in the Cardiology Department, as part of their medical training program.

Medical student

A student beginning studies in medicine who has been provided dedicated clinical time in the Cardiology Department.

Registered Nurse (RN)

A RN who provides nursing assessment for your child. This will include a discussion about family composition, medications and allergies. The RN will also weigh your child, measure their height, blood pressure and sometimes oxygen saturation. The nurse will call you if there are other tests that may be needed at the time of the visit.

Echosonographer

A specialized sonographer is trained in echocardiography and performs the echocardiogram testing for a physician to review.

Cardiology technologist

A specialized technologist who performs various electrophysiology testing such as ECG's, Holter monitor, exercise testing, tilt tests, cardio-pulmonary tests and hand out telephone transmitters.

Social worker

A social worker may meet with a patient and family to provide emotional support and care. In a time of crisis, the Social Worker is able to provide support and help identify resources within the hospital as well as the community.

Clinical manager

The Clinical Manager for Cardiology oversees the department.

Quality coordinator

A Registered Nurse who works with the Cardiology team to coordinate quality improvement activities, including regular review of patient charts to monitor quality of care and patient outcomes.

Patient service clerk

A member of the cardiology team responsible for organizing activities related to appointment scheduling. The appointments can be associated with clinic visits, testing, patient discussions and includes numerous confirmation calls. The PSC is often responsible for coordinating multiple appointments for families coming to CHEO.

Genetic counsellor

A genetic counsellor may meet with you at your cardiology visit, or during a separate appointment. Family history information will be reviewed, often based on a family history questionnaire and medical records, obtained with permission. Genetic counselling in Cardiology is available to individuals, families, or couples by referral.

Administrative support

They are members of the cardiology team responsible for administration support to the physicians and the department.

Frequently asked questions

What if my child suffers from palpitations?

Palpitations or the sensation of rapid or forceful heartbeat is a common symptom in children. If the episodes are brief and go away on their own they generally do not require treatment. It should be noted that children can obtain very fast heart rates with exercise or excitement. The sensation of rapid heart rate that comes on progressively with exercise and gradually settles at rest is likely normal. Rapid heartbeat associated with fainting is a concern.

Questions about heart murmurs

What is a heart murmur?

A murmur is an extra sound the heart can make when blood flows through it. Some murmurs are harmless (called ‘innocent’ ‘benign’ or ‘functional’). Some murmurs are not normal. Your child or teen will need some tests to see if the murmur is a problem or not.

What causes a heart murmur?

Innocent’ murmurs are extra noises made when blood flows through a normal heart. Abnormal
murmurs can be caused by many things, for example:

A defective heart valve
A ‘hole’ in the heart between heart chambers (ventricular/atrial septal defect)
Narrowing of one of the heart vessels.

Are heart murmurs common in children?

Yes. Heart murmurs are common in children. Most are harmless and go away as your child grows.

What are chest pains?

Chronic, recurrent chest pain in children is rarely related to the heart. Most chest pain in children comes from the chest muscles or the small joints between the ribs. Chest pain that occurs at rest and with exercise is generally benign. Pain that is described as “sharp” or “stabbing” is also less of a concern particularly if it is made worse by a deep breath. Pain occurring in association with meals may be caused by a common condition called gastroesophageal reflux, the result of stomach acid coming back up the swallowing tube.

What should I know about bacterial endocarditis?

Bacterial endocarditis is an infection of the inside lining of the heart or the heart valves. It is a serious but rare complication in some children with heart defects. It may occur after certain procedures, such as dental work. For cardiac patients with certain types of heart defects, a preventative dose (1 dose) of antibiotics may be prescribed prior to the procedure to decrease the chance of such an infection. Your cardiologist will be able to discuss with you whether your child requires this type of antibiotic treatment.

How do I access CHEO cardiac satellite clinics?

Normally the satellite clinics are organized for specific times in coordination with the regional hospital. Once families are referred, they have the option of seeing the cardiologist in Baffin Island, or seeing the cardiologist in Ottawa at CHEO.

As a patients, where can I direct my questions?

New patients who have been referred to a cardiologist at CHEO but have not yet been seen will need to call their family physician if they have questions about their child’s health. Until a cardiologist sees your child, your family physician or pediatrician remains the most knowledgeable about your child’s health. That is different once the child has seen a cardiologist.

For patients previously seen at the Clinic, inquiries can be directed to the Nursing Line at 613-737-7600, ext. 3109.

What will happen during our cardiac clinic visit?

Your appointment may last between two and three hours. During your clinic visit, we will:

take your child’s health history
examine your child or teen. A nurse will take your weight, height and blood pressure. Blood pressure may be taken with an automatic machine, or manually with a Doppler ultrasound
decide if further tests are needed

If your child or teen has tests during this visit, your cardiologist will discuss the results with you before
you leave.

How can I renew a prescription?

Don’t forget to ask for prescription renewals at your appointment.

What can I expect from electrophysiology testing?

We perform these tests:

Electrocardiogram (ECG)

An echocardiogram is an ultrasound of the heart. It allows us to evaluate the structure and function of the heart. We can also evaluate blood flow within the heart and blood vessels.

Echocardiograms are harmless and generally painless. They may take up to an hour and will require your child to stay still for one minute.

What to know:

Your child will need to be undressed from the waist up (short gowns are available).
All the echo rooms are equipped with TVs to be a form of distractions during echo.
Front closing onesies are helpful for infants.
Children under three years old may need to be sedated to have adequate pictures.
For our infants, feeding (by bottle) and the use of soothers help to keep them calm.
This test happens in darkened rooms.

Signal averages ECG (SAECG)

This will require your child to stay still for 5 minutes.

Holter monitor

Holter monitors are put on by our EP technicians for you to wear at home for 24 to 48 hours.

Stress tests

a running test done on a treadmill or bicycle.

These tests are performed to assess your child’s heart’s electrical system or activity and are used to diagnose abnormal heartbeats or arrhythmia.

Stickers will be applied to the skin, the technicians performing the test have different ways to remove stickers as pain free as possible.

What is your policy on taking photos in the clinic?

Please ask about our hospital policy before taking pictures in the clinic.It is not permitted to take pictures of testing. Written consent is required to take pictures of staff.

Cardiology testing

Electrophysiology

This is a simple investigation that measures the electrical activity of the heart. A variety of electrophysiology testing performed at CHEO includes:

ECG testing

This is a simple test that records your child’s heartbeats. Thirteen stickers are applied to your child's chest, arms and legs. Leads (insulated wires), which are connected to a machine with a screen, are then connected to each sticker. A recording of your child's heartbeats overlooking different views of the heart are printed out. Depending on your child's age, this test can take a minimum of 5 minutes if your child is relaxed, cooperates and stays still for the time needed (approx. 60 seconds)

Holter Monitor

This is a 24-hour recording of your child’s heartbeats, which is useful for assessing suspected abnormalities of the heart rhythm. Three stickers, similar to the ECG stickers are applied to your child’s chest and connected to a recorder about the size of a deck of playing cards. Your child cannot take a bath or shower while the recorder is on but otherwise should engage in normal daily activities.

Exercise (stress) test

An exercise test allows us to evaluate the response of your child’s heart to exercise. For this test, your child will need running shoes, loose clothing that they can run in, and a bottle of water. Your child is connected to 10 ECG stickers and a blood pressure cuff will be applied on one arm to monitor blood pressure. Your child will start off with a slow walk on the treadmill and then gradually increase the pace to running for as long as they can. After running, a cool down recovery period is observed. The test will take approximately 45 minutes.

Your child can have a light breakfast or lunch one hour prior to testing.

Signal Average ECG

This is a simple test that records and counts your child’s heartbeats. It is very similar to an ECG except a different part of the heartbeat is measured. Stickers are applied to your child’s chest and back. Leads (insulated wires), which are connected to a machine with a screen, are then clipped onto each sticker. Several pictures of your child’s heart will be taken. Your child will have to lie very still and quietly to ensure clear tracings are obtained. The test takes approximately 15 minutes.

Echocardiogram (Echo)

This is an examination of the heart by ultrasound. There is no radiation or risk involved in the procedure. It is used to detect structural and functional abnormalities, enlargement or inflammation of the heart, and other conditions. The test takes approximately 45 minutes. Generally, children between 3 months and 3 years of age require sedation in order to lie still for the procedure. A variety of specialized studies performed at CHEO includes:

Transthoracic echocardiogram (TTE)

A transthoracic echocardiogram is a test to check for problems inside and around your heart. A TTE is often called an echocardiogram or an "ECHO".

Harmless sound waves (ultrasound) are sent into the heart through your child’s chest wall. Parts of the heart like the walls and valves send echoes back to the machine that records the motion of the echoes to create a picture of the heart. This recording shows how your heart looks and works. No radiation from X–rays is used.

The test takes approximately 45 minutes. Generally, children between 3 months and 3 years of age require sedation in order to lie still for the procedure.

Transesophageal echocardiogram (TEE)

This is a test performed in the catheterization lab under sedation. A flexible tube is passed down the throat and into the esophagus (food pipe) until it is right behind the patient’s heart. Ultrasound waves sent from the tube are used to show the heart’s chambers and valves. Because the tube is close to the heart, the pictures from a TEE may give more details than a surface ECHO. This test does not hurt because your child is sedated at all times.

Fetal Echocardiography

A referral by an obstetrician is required. Fetal echocardiography is a test in which ultrasound waves are used to see the baby’s heart while still in the womb. Although the test does not use any radiation, it is a complex examination that can take up to two hours. The test is generally done between 18 and 24 weeks gestation. The reliability of the test is affected by the thickness of the mother’s abdominal wall and the amount of fluid present around the fetus. With good images, major abnormalities of the heart can be reliably detected but minor abnormalities of the heart cannot be ruled out until after the baby is born.

Cardiac catheterization (Cath)

Cardiac Catherization is a specialized procedure used to look inside your child's heart with the use of a special X-ray machine. This procedure is generally performed with anesthesia.

Catherizations are performed upon the request of your cardiologist. Prior to the procedure, your child will be seen in the pre-assessment unit and meet with the interventional cardiologist. Cases are booked according to urgency as determined by the cardiology team.

Diagnostic (investigative) and interventional cardiac catheterization procedures are conducted at CHEO:

Diagnostic catheterizations are done to learn more and/or diagnose your child’s heart condition. It also helps the cardiologist to determine the best treatment for your child.
Interventional catheterizations are performed to fix heart malformations. Many defects, once requiring surgery, can be repaired by the implantation of a device, stent or coil using interventional catheterization procedures.

Interventional catheterization

Coil occlusion

A coil occlusion catheterization is performed to close an unnecessary/abnormal blood vessel. By placing a catheter (hollow tube) in the blood vessel, a coil is pushed through a catheter and out into the blood vessel to be closed. The catheter is then removed once the coil is in place.

Angioplasty

Angioplasty is a procedure that uses a balloon catheter (hollow tube) to open a narrowed heart vessel. A balloon catheter is a type of hollow tube which has an inflatable "balloon" at its tip. The balloon catheter is inserted into the blood vessell when it is deflated and once in position, it is inflated to perform the procedure and is deflated again for removal. The balloon may need to be inflated and deflated several times to stretch the blood vessel.

Angioplasty with stent implanted

An angioplasty with stent implantation is a procedure, which is performed when the blood vessel does not stay stretched after angioplasty. A stent (wire mesh) is inserted into the blood vessel and expanded. The stent will remain after the balloon catheter is removed to hold the blood vessel open. This procedure may need to be repeated as your child grows.

Device closure

This procedure is used to insert a device to close a hole between two chambers of the heart. There are a variety of devices available for implantation depending on the size and location of the hole.

Valvuloplasty

Valvuloplasty is a procedure that uses a balloon catheter (hollow tube) to open a narrowed heart valve. A balloon catheter is a type of hollow tube which has an inflatable "balloon" at its tip. The balloon catheter is inserted into the valve when it is deflated and once in position, it is inflated to perform the procedure and is deflated again for removal.

Need more information?

Visit the cardiology resource section to learn about a variety of health topics for children and youth and access CHEO recommended websites, books, apps, videos and more!
Resources and support