Cardiology
Apex Cardiovascular Services

Dr. A. Mahim MD MSc FRCPc

Dr Mahim completed his undergraduate degree at University of Toronto in Biology. He then studied medicine at the American University of the Caribbean prior to doing an internal medicine residency in Southfield Michigan in association with Wayne State University and Providence Hospital. After practicing as a general internist for several years, he chose to follow his heart into Cardiology. His cardiology fellowship was at London Health Sciences Center.

Dr Mahim has been active in promoting excellence in diagnostic imaging and cardiac care for his patients and for the community at large, one patient at a time. He has helped in establishing Cardiac Rehab services as well as sat on the Cardiac Services Planning Committee for the province of New Brunswick. He has been an early adopter of EMR as well as utilizing cutting edge digital technology.

In 2008 he moved to the Kawarthas and has made Peterborough his home. Here he established Apex Cardiovascular Services and Apex Diagnostics Services, providers of Cardiology as well as Radiology services for the region. With well over five thousand patients and counting, Apex has been instrumental in complementing medical care to the region thru Dr Mahim and his fellow associates.

Click here for the Apex Cardiovascular Services Requisition

Click here for the Apex Diagnostic Services Requisition

Cardiac Testing Provided

• Apex Diagnostic Services  (1757 Sherbrooke St.)
• Dobutamine Stress Echo
• Exercise Stress Echo
• Echo Doppler
• Exercise Stress Test (treadmill)
• Holter Monitors
• Ambulatory Blood Pressure Monitors
• Electrocardiograms
• General Ultrasound
• X-ray
• Bone Mineral Density
• Nuclear Medicine Imaging

Located at the corner of Sherbrooke and Brealey, in a Navy Blue Building. Patient Parking lot entrance, and Front Door is located on Brealey Dr.
Do NOT park in Sherbrooke St. Parking lot.

Dobutamine Echo

A Dobutamine Echo is used to help the physician diagnose any potential structural or functional cardiac abnormalities. The test is commonly requested for coronary disease.

Before showing up to the office for the test:

• Do not apply any oils or lotions to the skin 24 hrs before the test
• Make sure you withhold any medications as directed
• Bring all medications you are taking, or an up to date prepared list of all medications you are taking
• Do not eat a heavy meal before the test

During the test:

• You will be hooked up to a 12 lead heart monitoring system which will monitor your heart rhythm and rate throughout the duration of your stress test
• You will also be hooked up to an IV line used to administer medications during your test
• A baseline electrocardiogram and blood pressure will be taken at the beginning of your test
• A physician will briefly asses you before the test to ensure your safety
• A small amount of special sound conductive gel will be applied to your chest and an ultrasound of your heart will be done (the gel may have a cool feeling to the skin)
• A special medication called Dobutamine will be given to you through the IV line. This medication is meant to do the same function as if you were on a treadmill speeding up your heart rate.
• When the required heart rate is reached, the infusion of Dobutamine will be stopped and another ultrasound will be performed on your heart while it’s beating quickly
• You will then be monitored for a period of time until your heart rate return to a safe rate

If at any time during the test you feel unwell, please let the Ultrasound Technician, Cardiology Technologist or Nurse performing your test know. Symptoms may include Chest Pain or Tightness, Shortness of Breath, Dizziness.

Stress Echo

A Stress Echo is used to help the physician diagnose any potential heart arrhythmias, structural or functional cardiac abnormalities. The test is commonly requested for coronary disease.

Before showing up to the office for the test:

• Do not apply any oils or lotions to the skin 24 hrs before the test
• Make sure you are wearing non restrictive clothing to do exercise in and bring or wear running shoes
• Make sure you withhold any medications as directed
• Bring all medications you are taking, or an up to date prepared list of all medications you are taking
• Do not eat a heavy meal before the test

During the test:

• A registered Ultrasound Technician and Cardiology Technologist will be performing your stress echo test
• You will be hooked up to a 12 lead heart monitoring system which will monitor your heart rhythm and rate throughout the duration of your stress test
• A baseline electrocardiogram and blood pressure will be taken at the beginning of your stress test
• A physician will briefly asses you before the test to ensure your safety
• A small amount of special sound conductive gel will be applied to your chest and an ultrasound of your heart will be done (the gel may have a cool feeling to the skin)
• You will then be put on the treadmill you will start out at a slow walk on a slight incline and the treadmill will increase slightly in speed and incline every 3 minutes
• This increase of incline and treadmill speed will continue until a specific heart rate is reached
• When the required heart rate is reached the treadmill will be stopped
• You will then be asked to return quickly to the bed to lie down and another ultrasound will be performed on your heart while it’s beating quickly
• You will then be monitored for a period of 5 minutes or more to ensure your safety

If at any time during the test you feel unwell, please let the Ultrasound Technician, Cardiology Technologist or Nurse performing your test know. Symptoms may include Chest Pain or Tightness, Shortness of Breath, Dizziness or just plain Fatigue.

GXT

A GXT or “Stress Test” is used to help the physician diagnose any potential heart arrhythmias or angina from blockages in the coronary arteries in the heart.

Before showing up to the office for the test:

• Do not apply any oils or lotions to the skin 24 hrs before the test
• Make sure you are wearing non restrictive clothing to do exercise in and bring or wear running shoes
• Make sure you withhold any medications as directed
• Bring all medications you are taking, or an up to date prepared list of all medications you are taking
• Do not eat a heavy meal before the test

During the test:

• A registered Cardiology Technologist or nurse will be performing your stress test
• You will be hooked up to a 12 lead heart monitoring system which will monitor your heart rhythm and rate throughout the duration of your stress test
• A baseline electrocardiogram and blood pressure will be taken at the beginning of your stress test
• A physician will briefly asses you before the test to ensure your safety
• When on the treadmill you will start out at a slow walk on a slight incline and the treadmill will increase slightly in speed and incline every 3 minutes
• This increase of incline and treadmill speed will continue until a specific heart rate is reached
• When the required hear rate is reached the treadmill will be slowed down to a stop.
• You will then be monitored for a period of 5 minutes or more to ensure your safety

Holter Monitoring

A Holter Monitor is used to help the physician diagnose any potential arrhythmias of the heart during normal daily activities and during deep sleep at night.

Before showing up to the office for the test:

• Do not apply any oils or lotions to the skin 24 hrs before the test
• Please have a shower or bath as you will not be able to have another one until the testing is done, usually 48 hrs later.
• You may wear your normal everyday clothes or business attire if needed

During the test:

• An electrocardiogram or ECG may be performed at the start of the test
• There will be 5 electrodes placed at specific locations on your chest and the holter monitor will be connected to them
• The holter monitor will be worn continuously for 24 hrs or 48 hrs
• You may go about your normal daily activities while wearing the holter monitor
• While wearing the holter monitor if you have any cardiac symptoms such as chest pain/tightness, S.O.B., dizziness, palpitations you need to press the event button and record in the diary sheet provided to you what your symptoms were. This is very important as this can determine how the physician will treat you based on your test results.
• While at home wearing the holter monitor you may refer to the diary sheet provided to you with regard to what you need to know about the monitor
• Please return the holter monitor on time so as to not incur any late fees.

At the end of the Test

• You may take the holter monitor off at home at the end of the monitoring period
• Please remove the battery in the back of the monitor (this will shut it down) before you disconnect the wires
• After you disconnect the wires, the 5 white electrodes may be disposed of in the garbage
• Return the holter monitor, carrying case and wires along with your diary sheet, in the plastic bag provided
• Out of courtesy, return the holter monitor ON TIME as instructed, as others are waiting for their holter monitor testing as well
• Return monitor to the front reception desk of APEX Cardiology where you check in

ABP

Ambulatory Blood Pressure Monitoring takes numerous readings of your blood pressure over a 24 hr period. It provides accurate and reliable information and gives your doctor a true picture of how your blood pressure fluctuates over the course of an average day in your life.

This test is not covered by OHIP and a charge of $50.00 cash only, is payable at time of hookup. You will be provided with a receipt that you can submit to your insurance carrier should it be covered by them.

Before showing up to the office for the test

• Do not wear a tightly fitting shirt

During the test

• A Blood pressure check will be taken on each arm to check for your baseline reading
• A blood pressure cuff is attached to your arm and is connected through a hose to an air pump which you carry in a pouch over your shoulder
• The Ambulatory Blood Pressure monitor is programmed to record a blood pressure reading every half hour during the daytime and every hour during the nighttime while you are sleeping
• You may go about your normal daily activities while wearing the Ambulatory Blood Pressure monitor
• Out of courtesy , please return the monitor ON TIME as instructed, as others are waiting for their BP monitor testing as well. Otherwise a $50 late fee will be charged to you.
• Return the monitor ON TIME to the front reception desk of APEX Cardiology where you check in

Office Policies

We do not give test results or medical advice over the phone due to confidentiality concerns. Test results and consultation letter are forwarded to your family physician when available. These results can be obtained from your family physician or at your appointment with the cardiologist.

We do not renew prescriptions over the phone or at Pharmacy request. Please call your Family Physician to do so.

Please refrain from wearing lotions or oils before any tests to insure tapes stay in place. Please refrain from wearing any perfumes or colognes due to allergy concerns.

Please bring an updated list of medications or preferably the medications in their bottles to your appointments.

Due to the nature of the tests and the room size, we would ask that family members wait in the waiting area until the tests are complete. As always, depending on the circumstances, exceptions can be made at the discretion of the physician.

Any damage to equipment while in your possession will be your responsibility to replace. Our cardiac testing devices are costly. For example the charge to you for replacement of one holter monitor is $3000.

As a courtesy to others, please be mindful that missed appointments result in unnecessary wait times for others. You have been assigned a specific date and time for a cardiac test or office appointment. Staff, equipment, and space have been reserved for you for that time. All of these appointments are costly. Accordingly, if you do not attend and have not given adequate notice, you will be charged for the expenses for that visit. You cannot recover these expenses from the government. Please make every effort to attend, or cancel/reschedule if unable to attend.

Emergencies: The fee for failing to attend will not be charged in the event of a weather or personal emergency. However, please notify us as soon as you know you can’t make it.

If you do not show up for an appointment without proper notice, you will receive an invoice for the following amount, payable by cash or cheque only:

• Office appointments: $50
• All Diagnostic Services: Up to $100

How to Reach Us

Note: You will always get a recording, but our staff will return your call at their earliest opportunity. When leaving a message, clearly state your name and date of birth, as well as the nature of your call.

Office Hours