2300 , Suite 906, Toronto, , M4P 1E4 HEART CENTRE Website: www.torontoheartcentre.ca

Tel: (647) 776-2500 Fax: (647) 260-0279 Email: [email protected]

Our Team Patient Name: ______Cardiologists Dr. Beth Abramson Health Card: ______D.O.B. ______Dr. Kamran Ahmad Dr. Abdul Al-Hesayen Phone No. (O) ______(C) ______(H) ______Dr. Asim Cheema Email: ______Gendar: ______Dr. Chi-Ming Chow Dr. Robert Chisholm Patient Address: ______Dr. Paul Dorian Dr. Neil Fam Consultation (Please forward the most recent test results) Dr. David Fitchett Dr. Michael Freeman First available cardiologist Dr. ______Dr. Anthony Graham Dr. Victoria Korley Please arrange for cardiology consultation to review test results Dr. Michael Kutryk Dr. Iqwal Mangat Diagnostic Tests (Please see back for patient instructions) Dr. Gordon Moe Dr. Juan Carlos Monge At Heart Centre Site (2300 Yonge St.) – Cardiovascular Diagnostics Dr. Andrew Yan Echocardiography ECG

Exercise Stress Test (GXT) Exercise Stress Echo Our Services 24-hour Holter Monitoring 48-hour Holter Monitoring General Cardiology Cardiac Arrhythmia Loop Monitoring Ambulatory Blood Pressure Monitor Heart Failure At St. Michael’s Hospital Site (30 Bond St.) – Vascular Ultrasound Valvular Heart Disease Hypertension Carotid ☐ Abdominal Aorta Aneurysm ☐ ABI Screening Cardiac Risk Assessment ☐ Arterial Lower Extremity ☐ Arterial Upper Extremity Echocardiography Holter Monitoring ☐ Venous Lower Extremity ☐ Venous Upper Extremity Loop Monitoring At St. Michael’s Hospital Site (30 Bond St.) - Nuclear Cardiology Stress Testing Stress Echo Myocardial Perfusion (MIBI) Exercise Persantine Dobutamine Ambulatory BP Monitor Ventricular function (MUGA) Rest Exercise Vascular Ultrasound (at St. Michael’s Hospital) Nuclear Cardiology Reason for Referral: ______(at St. Michael’s Hospital) ______

Referring Physician: ______

Billing No. ______Date: ______

Address: ______

Tel: ______Fax: ______

Avenue Road Duplex Avenue Yonge Street Mt Pleasant Road

Lawrence Avenue

Eglinton Avenue

Chapline Crescent Davisville Avenue

St. Clair Avenue

Directions to Our Clinic

TTC: Exit subway at Eglinton subway station (the Yonge-University-Spadina Subway line), through the food court towards Yonge/Eglinton Centre. Follow direction inside the shopping mall to 2300 office tower elevators. From Don Valley Parkway: Exit at , go west on Eglinton Avenue to Yonge Street, and go north on Yonge Street. Our clinic will be on your left side inside the Yonge/Eglinton Centre. From 401: Exit at Yonge Street, go south on Yonge Street to Eglinton Avenue. Our clinic will be on your right side inside the Yonge/Eglinton Centre. Parking: Underground parking inside the Yonge/Eglinton Centre, enter from Orchard View Blvd off Yonge St. Outdoor parking lot on Orchard View Blvd, or along Yonge Street meter parking (limited time zone). Parking fees apply.

Diagnostic Tests Preparations

Exercise Stress Test (GXT) / Exercise Stress Echo:

• Light breakfast / lunch on the day of test • Wear comfortable shoes, T-shirt, shorts or pants • No smoking 1 hour prior to testing • Bring all current medications, and check with your physician regarding the discontinuation of any related medication.

Vascular Ultrasound:

• No caffeine (coffee, tea, cola, decaffeinated products, chocolate, medications containing caffeine) on day of test • Low fat meal the night prior to the date of test • Nothing solid to eat on the morning of the test • Take one bowl of jello on the morning of the test (for gas reduction) • If you are diabetic, you should follow your regular diet regimen