Outpatient referrals for diagnostic cardiac catheterization or angioplasty must be made by a cardiologist. To refer a patient, complete the Patient Registry Form (pdf) and fax to 613-696-7144.
For questions or to advise of changes in patient status, contact the Regional Cardiac Care Coordinator at 613-696-7000 x19733.
Outpatient referrals for diagnostic tests can be made through Ocean eReferral, which enables most community physician EMRs to conveniently create and submit requisitions directly. If you are not already set up with access to Ocean eReferral and are interested in learning more, please contact Champlain_eReferral_Team@lhins.on.ca.
Referrals for admitted patients can be made by a cardiologist or internist. Complete the Patient Registry Form (pdf) and fax to 613-696-7144. For questions or to advise of changes in patient status, contact the Regional Cardiac Care Coordinator at 613-696-7000 x19733.
Cardiac Diagnostic Imaging and Other Tests
There are a number of tests used to diagnose various conditions that affect the heart. Use the General requisition form unless otherwise specified.
- Cardiac Diagnostic and Imaging Requisition - General (pdf)
- Cardiac Diagnostic and Imaging Requisition - CT, MRI, X-RAY (pdf)
The following algorithms can help guide the appropriate selection of tests:
- 24-Hour Ambulatory Blood Pressure Monitoring
Fill out the 24-HR-ABPM Requisition (pdf), save for your files, and either email to 24-HR-ABPM@ottawaheart.ca or fax to 613-696-7125.
- Ambulatory ECG Monitoring (Holter)
- Ambulatory ECG Monitor (LOOP)
Cardiac CT/Non-Invasive Angiography
- CT Coronary Angiography
- Coronary Calcium Score
- Pulmonary Vein and Left Atrium Study
Cardiac Structure and/or Function Assessment
- Echocardiography (Colour Doppler)
- Transesophageal Echocardiography (TEE)
- Ventricular Function and Volume Scan (MUGA/Radionuclide Blood Pool Imaging)
- Cardiac MRI (Anatomy & Function)
Stress Testing/Ischemic Testing
- Cardiopulmonary Exercise Test
- Exercise Treadmill Stress Test
- Stress SPECT Myocardial Perfusion and Function (exercise or persantine)
- Stress PET Myocardial Perfusion and Function (persantine or dobutamine)
- Stress Echocardiography (exercise or dobutamine)
- Cardiac MRI (Viability, Cardiomyopathy)
- Cardiac PET (Viability, Sarcoidosis)
- CADRE FDG PET Requisition (pdf) – refer a patient for a PET viability (rest) scan. More information on F-18-FDG can be found in the FluorOHmet product monograph (pdf); by contacting the Sponsor, University of Ottawa Heart Institute, National Cardiac PET Centre, at: 1-855-864-4334; or through the Health Canada Health Products and Food Branch Inspectorate.
Other Imaging Tests
- Chest X-Ray
- Carotid Doppler
- Femoral Doppler