Cardio-Obstetrics Clinic

The Cardio-Obstetrics Clinic is a specialized outpatient cardiology clinic that provides comprehensive cardiac care for women before, during, and after pregnancy.

Services provided include pre-conception counseling and pregnancy-related cardiac risk assessment, contraception counseling for women with heart disease, assessment of cardiac symptoms arising during pregnancy or within 1 year of delivery, in addition to comprehensive evaluation and follow-up of women with structural heart disease during and after pregnancy (see below for comprehensive list of referral indications).

The clinic also provides individualized care plans for labor, delivery, and postpartum for women with acquired and non-complex congenital heart disease. Our clinic works in close collaboration with Obstetrics, Maternal-Fetal Medicine, Internal Medicine, Genetics, Anesthesiology, Cardiac Rehabilitation, and other specialties as needed.

Indications for referral include:

• Pre-pregnancy cardiac risk assessment and/or planning.
• Contraception counseling in women with heart disease or multiple cardiovascular risk factors.
• New cardiac symptoms in pregnancy or within 12 months of delivery (chest pain, dyspnea, palpitations, other).
• Pregnant and with a history of one or more of following: 
  • Heart failure.
  • Cardiomyopathy.
  • Valvular heart disease (mitral stenosis, more than mild aortic stenosis, moderate to severe valvular regurgitation); prosthetic valves.
  • Arrhythmia (sustained supraventricular tachyarrhythmia that has not been successful ablated, atrial fibrillation/flutter, sustained ventricular arrhythmia).
  • Cardiac devices (pacemaker, ICD).
  • Pregnancy-associated spontaneous coronary artery dissection (P-SCAD).
    • Please note that women with SCAD occurring postpartum should be referred to the Women's Heart Health Clinic instead.
  • Myocardial infarction.
  • Aortic disease (prior aortic dissection, known thoracic aortic aneurysm, predisposing condition including but not limited to Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome, Turner syndrome, etc.).
  • Pericardial disease (recurrent pericarditis, pericardial constriction, more than mild pericardial effusion).
  • Postural orthostatic tachycardia syndrome.
  • Non-complex adult congenital heart disease (bicuspid aortic valve, atrial septal defect, ventricular septal defect, etc.). 
    • Please note that patients with COMPLEX ACHD (Eisenmenger syndrome, unrepaired cyanotic heart disease, Fontan, etc.) should be referred to the Adult Congenital Heart Disease Clinic instead.

Please note that women with hypertensive disorders of pregnancy (gestational hypertension, preeclampsia, eclampsia, HELLP syndrome) and/or gestational diabetes should be referred to the Internal Medicine Special Pregnancy Unit or the Postpartum Vascular Risk Reduction Clinic at The Ottawa Hospital, as appropriate.

Patient Instructions

When your doctor refers you to the Cardio-Obstetrics Clinic, a UOHI cardiologist reviews your information. A UOHI staff member will contact you to book your appointment and any tests required in advance.

Prior to your consultation with the cardiologist, you will have a virtual visit with our clinic nursing team to discuss your medical history.

At your consultation, your cardiologist will perform a full assessment of your cardiac and reproductive health, history, and treatments. Any tests arranged as part of this visit will also be reviewed. 

Please bring your list of medications with you and if available, copies of any relevant records you may have from outside facilities.

Referrals

Referrals are accepted from physicians or nurse practitioners.

Referrals from within TOH or UOHI are through EPIC (Ambulatory Referral to Cardiology).

Referrals from outside TOH or UOHI should complete the referral in OCEAN.