Cambridge Cardiac Care Centre

Rapid Access Chest Pain Clinic

Rapid Access Chest Pain Clinic provides fast-track assessment

Minimizes cardiac complications and buys time for your heart health.

The Rapid Access Chest Pain Clinic provides swift, early cardiovascular assessments for patients with newly presenting chest pain symptoms and for patients with known and worsening ischaemic heart disease who need to be seen urgently.

This cardiologist-led clinic provides a “fast-track” to appropriate cardiac investigations and treatment. The chest pain clinic was created in partnership with local hospitals and health care teams to help reduce stress on local hospitals while also improving ER patient outcomes. We do this by ensuring non-invasive, patient-friendly cardiac testing, often within 48 - 72 hours of your ER visit. The only requirement is a referral from the hospital or your healthcare provider.

Benefits of an out-patient Rapid Access Chest Pain Clinic

Patients who show up with chest pain symptoms in the ER statistically have a better chance of avoiding cardiac complications when they receive a rapid assessment by a cardiologist. Benefits of an out-patient chest pain clinic include:

  • Rapid Access non-invasive testing
  • Decreases ER wait times
  • Reduces length of stay at the hospital
  • Minimizes complications and buys time for heart health
  • Reduces the stress and anxiety of waiting for answers.
  • Decreases load on the health care system

The Chest Pain Team

Multi-disciplinary but with a single focus

Guided by our lead physician and dedicated Chest Pain Clinic nurses, this innovative program was designed to ease the burden placed on local hospitals while ensuring timely access to patients who have experienced not only chest pain but also all the fears and anxieties that come along with it. The greatest strength of this novel regional program is the elaborate team of allied health care professionals who are made available to Chest Pain patients through our unique P.R.E.V.E.N.T. Cardiac Rehab and Risk-reversal Clinic. Focusing on accurate diagnosis, event-prevention, comprehensive therapy and lifestyle intervention, patients receive personalized, proactive, guideline-based care in a supportive environment.

Patient Education

Why am I being sent to the Rapid Access Chest Pain Clinic?

Often the initial visit to our Rapid Access Chest Pain Clinic is arranged by the emergency department physician who would have attended to your chest pain at the hospital. Sometimes, however, you may have seen your family doctor, walk-in clinic or urgent care physician who can make the same call. In any case, the physician would have suspected a potential for heart disease based upon your symptoms and cardiac risk factors. They would have referred you to our Rapid Access clinic to determine your risk for coronary artery disease (CAD) and to help prevent possible future cardiac events from occurring.

What can you expect at your first appointment?

Upon arriving at Cambridge Cardiac Care, please register with our friendly staff at the reception window. You will first be called in by a technologist who will commence your cardiac testing which may include an ECG, Echocardiogram, Holter Monitor, ABPM, Stress Test and Stress Echocardiogram. Upon completing the full workup, you will meet with the specialized cardiac nurse or the cardiologist who will review your test results and consult with you regarding your risk for coronary artery disease (CAD), may suggest further testing and possibly commence an appropriate treatment plan. Follow up appointments may be suggested as well.

How to prepare for your first appointment?

Since you will be undergoing cardiac testing at your first appointment, it is important to follow the following instructions. You may also visit the test-specific pages on our website to get more detailed information in advance of your appointment.

General Cardiac Testing Instructions:

  • Shower in the morning, before your appointment.
  • Do not wear lotions or body oil.
  • Do not wear jewelry or perfume.
  • Wear comfortable exercise clothing to your appointment.
  • Eat a light meal 2-3 hours before your appointment.
  • Stay away from caffeine. No coffee, tea, chocolate, soda pop, or decaf products.
  • Bring running shoes to change into during your appointment.
  • Bring a bottle of water and a light snack just in case.
  • Bring a list of all your medications.
  • Bring your health card and referral requisition.
  • Be prepared to be in the clinic for up to four hours.

What causes chest pain?

Chest pain or discomfort may be the result of many differing conditions, some of which may not be cardiac in nature. Having chest pain does not necessarily mean you are having a heart attack. However, since chest pain can be a sign of a cardiac event, it is important to get assessed as quickly as possible.

Heart-related chest pain may be caused by any one of the following. If you suspect one of these to be the case and you have ongoing chest pains, call 911 immediately and have an ambulance take you to the hospital.

Chest Pain of Cardiac Origin

Angina is a term for chest pain that is caused by the narrowing of coronary arteries (the blood vessels that feed the heart muscle itself) and is a sign of Coronary Artery Disease (CAD). This narrowing, known as atherosclerosis, occurs as a result of fatty plaque depositing on the inner lining of the blood vessels. Over time, the growing fat deposits prevent a normal amount of oxygen-rich blood from reaching the heart muscle, known as cardiac ischemia. It is vitally important to have angina symptoms followed up by a cardiologist. Take your angina seriously.

Angina is particularly common during physical activity, when the heart rate and blood pressure increase due to the heart's demand for more oxygen. This type of chest pain develops when the heart’s demand for oxygen exceeds the amount of oxygen that is being delivered by the narrowed coronary arteries.

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Heart attack (Myocardial Infarction)
The chest discomfort caused by a heart attack (an MI) may feel like a prolonged and more intense episode of angina. It must be taken seriously. In this case, the fatty plaque deposit in the coronary arteries has ruptured causing a blood clot. This blood clot (thrombus) may partially or even completely block blood from flowing to the heart muscle. If blood flow is obstructed for more than 15 minutes, the muscle may become permanently damaged (infarcted), killing the tissue in that area. Yes, it is indeed as serious as it sounds.

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Other cardiac causes of chest pain

Variant angina
Chest pain may sometimes be caused by a temporary spasm of the coronary arteries. In this case, patients experience a similar type of pain to classic angina however, in variant angina the arteries are usually normal with little to no plaque-related narrowing or obstruction. The spasm itself may result in a temporary, partial blockage to blood flow.

Chest pain may occur due to an inflammation of the membranes that surround the heart. This type of chest pain usually intensifies with deep breathing, coughing or sneezing. In this case, pain may be relieved by sitting forward.

The heart muscle itself may become inflamed, causing chest pain that mimics angina. Usually myocarditis is caused by a viral infection or autoimmune conditions.

Heart valve or muscle conditions
Conditions such as hypertrophic cardiomyopathy, mitral valve prolapse and aortic stenosis may cause chest pain. All of these conditions have different rates of progression and require different types of followup or cardiac workup.

Aortic dissection
Aortic dissection is an uncommon but very serious cause of chest pain that often requires emergency surgery. The pain of an aortic dissection is often described as a severe ripping or tearing sensation that comes on suddenly and is felt especially in the back and between the shoulder blades. An aortic dissection occurs when the inner wall of the aorta (the body’s main artery) ruptures or tears. As a result, blood begins to flow out of the artery and floods in the body cavity, similar to how a split in a garden hose would cause uncontrolled flooding of a garden.

How long will the initial appointment last?

The initial assessment appointment at the Rapid Access Chest Pain Clinic may take up to 4-hours. As such, it is best to be prepared with a bottle of water and a light snack in case the appointment runs long. The duration will depend on what specifically is being investigated in your case.

Do I take my medications on the day of my appointment?

Some patients may be required to discontinue taking certain medications the day of their initial assessment. This does not, however, apply to all patients. So, please, do not stop any medications on your own without the express instructions of your healthcare provider. If you are instructed to suspend certain medications on the day of your appointment, you may resume taking them immediately upon completing the necessary cardiac tests.

What tests might I need?

Accurate diagnosis means the right tests, by the right people, at the right time.

It is important to determine exactly what is going on, and why, in order for your cardiologist to develop an appropriate plan of care. You can expect to have some, or all, of the following tests done in preparation for your assessment by the cardiologist:

Physical Exam

  • Come prepared knowing your symptoms, medical and family history!
  • Measurements of blood pressure, height & weight and listening to heart & lungs stethescope
  • Be completely honest! It's your health!

Blood Test

  • Blood tests may be done at any lab that is convenient for you. Some blood tests require you to fast 8-10 hours, others do not. Please check the requisition or check with your health care provider.
  • Blood tests help determine your risk for development or progression of various heart diseases.
  • Measurements of substances like liver enzymes, sodium, potassium and creatinine can indicate the health of other organs that may be effected by heart disease.
  • Biomarkers like BNP might also be used for diagnosis of heart failure (CHF).

Chest X-Ray (CXR)

  • Chest X-rays are performed in radiology labs
  • Chest x-rays can show whether the heart is enlarged (like in heart failure)
  • Chest x-rays can also show fluid or congestion in the lungs

Electrocardiocgram (ECG)

  • During an ECG, electrodes are placed on the chest and detect the electric signals in the heart
  • This can indicate prior heart attacks, and abnormal heartbeats (like atrial fibrillation)
  • They can also be used to detect whether the left ventricle is thickened/enlarged
  • Electrocardiocgram testing at CCCC

Echocardiogram (Echo)

  • An echo machine bounces sound waves off the heart to examine its structure and motion of fluids like blood
  • This can be used to measure the structure of the heart (how thick/rigid the walls are) and how well the heart pumps (ejection fraction) as well as the structure and function of valves
  • They can also be used to detect whether the left ventricle is thickened/enlarged
  • Echocardiography testing at CCCC

Stress Test

  • In a stress test, you will exercise on a treadmill while equipment measures your heart
  • Stress tests examine the response of the heart to exertion and whether blood flow to the heart is impaired
  • Stress tests help determine what kind of exercise is appropraiate
  • Stress testing at CCCC

Nuclear Imaging (MIBI/MUGA)

Cardiac Catheterization / Angiogram

  • A very thin tube called a catheter is inserted into a blood vessel and threaded towards the heart
  • A dye is released that is visible by x-ray
  • The movement of the dyed fluid throughout the heart can show blocked or narrowed arteries as well as how much blood is flowing through the heart
  • Cardiac Catheterization Lab at St. Mary's General Hospital

Chest Pain Testing

Accurate diagnosis means the right tests, by the right people, at the right time.

Chest pain can take many forms and is caused by a number of conditions, not always cardiac in nature. It is important to determine exactly what is going on, and why, in order to develop an appropriate plan of care. Chest pain patients can expect to have the following cardiac tests done in preparation for their initial cardiologist consultation:

  • ECG
  • Echocardiogram
  • Holter Monitor
  • ABPM
  • Stress Test
  • Stress Echocardiogram
  • Blood Tests
  • Cardiac perfusion scan (aka MIBI scan) - performed off-site. Assesses blood flow through the heart.
  • CT angiography: performed off-site. Assesses the heart and the blood vessels by CAT scan.
  • Cardiac Catheterization - performed off-site. Usually only recommended for patients at higher risk of coronary artery blockage.

Why you need prevention-rehab now.

The P.R.E.V.E.N.T. & Rehabilitation Clinic

If you have been referred to the Chest Pain clinic, you have direct, Rapid Access to our P.R.E.V.E.N.T. Rehabillitation & Risk-reversal Clinic: the largest unit of its kind in the region. Why? Because in many cases, time is of the essence. Studies show that cardiac rehab can reduce the risk of future cardiac events and disease progression by upto 90%! Initial chest pain symptoms do not have to result in progression of heart disease, if you start managing it now by making lifestyle changes and adhering to recommended therapies. Learn how at The P.R.E.V.E.N.T. Rehabillitation & Risk-reversal Clinic.

Wait Times

Drag to see the table

Cardiac Test Routine Test Wait Time Urgent Test Wait Time
ABPM 2 weeks Same day
ECG 24 hours Same day
Echocardiogram 2 weeks 36 hours
Stress Test (Exercise / Treadmill) 2 weeks Same day
Stress Echocardiogram 2 weeks 24 hours
Holter Monitor - 24 Hour 2 weeks 24 hours
Holter Monitor - 48 Hour 2 weeks 24 hours
Holter Monitor – 72 Hour 2 weeks 48 hours
Holter Monitor - 2 Weeks 2 weeks 48 hours
Spirometry 24 hours Same day

The above wait-times indicate the standard benchmarks that Cambridge Cardiac Care strives to meet each and every day. Unforeseen circumstances and Public Health mandates, may effect these wait times. Rest assured that timely access is a driving force at CCC: we will get you in as soon as possible, based on your assessed level of urgency.