Respirology

St. Michael’s houses Ontario’s only Bronchiectasis Clinic, which sees patients from across the province. This multidisciplinary clinic accepts referrals for consultations to address the cause of bronchiectasis and create treatment plans.

St. Michael’s is home to the largest adult cystic fibrosis (CF) program in Canada. In addition to providing multidisciplinary care to over 600 adults with CF, we are an active site for clinical research and training of health professionals. We collaborate with SickKids to facilitate the transition of 15 to 20 adolescents with CF to our adult program each year and the Toronto Lung Transplant Program at University Health Network.

At our General Respirology Clinic, we diagnose and treat many common lung diseases such as asthma, chronic bronchitis, emphysema, pulmonary fibrosis, lung infection  and inflammation. We also investigate and diagnose many abnormalities which may be noted on chest X-rays and CT scans of the lungs like pulmonary nodules (benign and malignant). At this clinic, we are also able to diagnose and treat some non-specific symptoms, even if there is no underlying lung disease, such as cough.

Hepatopulmonary syndrome (HPS) is a rare complication of liver disease. When the liver is not functioning properly, blood vessels in the lungs may dilate as a result. If this is severe enough, the lungs can lose their ability to effectively transfer oxygen to the blood, which leaves patients with a low oxygen level and feeling short of breath.

Founded in 2005, the Hepatopulmonary Syndrome Clinic is part of the Rare Lung Disease research program at St. Michael’s. Since then, we have seen hundreds of patients at the clinic as well as our satellite location in Montreal. Our clinic specializes in the diagnosis and care of patients with HPS, as well as cutting-edge research in this field. Through our research initiatives, we aim to improve our understanding of HPS and maximize the quality of care we provide our patients.

The Toronto Hereditary Hemorrhagic Telangiectasia (HHT) Centre at St. Michael’s provides comprehensive care to approximately 1,500 people with HHT. Established in 1997, the centre is the largest of its kind in Canada.

Our multidisciplinary centre provides state-of-the art diagnosis and treatment for all aspects of HHT. The team has led the International HHT Guidelines for clinical care. We are also an active site in clinical and basic HHT research, as well as HHT training. The centre’s medical director is Dr. M. Faughnan, who leads a team of 20 physicians and health professionals with HHT expertise.

The Adult Primary Ciliary Dyskinesia (PCD) clinic at St. Michael’s provides comprehensive care to adults with PCD. PCD is a rare genetic disorder. Roughly half of patients with ciliary dyskinesia have situs inversus, a condition where organs, like the heart, are on the opposite side of their body.

In PCD the cilia, which are tiny hair like structures that line the surfaces of many parts of the body, either do not move properly or are absent. PCD patients may have bronchiectasis, sinus disease, middle ear disease, and fertility issues. We have access advanced diagnostic modalities for PCD including nasal nitric oxide testing.  A genetic counsellor is also available on site.

Our Pulmonary Function Laboratory offers a wide range of breathing tests. You will be asked to perform various breathing procedures through a mouthpiece connected to electronic equipment or exercise.

Some of the tests we provide include:

• Pulmonary function test (breathing test)
• Spirometry/flow-volume loop (breathing test)
• Methacholine challenge (asthma test)
• Exercise-induced asthma test
• Exercise testing on a bicycle or treadmill
• Arterial blood gases (blood test)
• Walk test to measure oxygen level and heart rate
• Home oxygen assessment and set-up

Tuberculosis (TB) is one of the most common infectious diseases worldwide and when left untreated, kills approximately 1.2 million people each year. In Canada about 2,000 people are diagnosed with active Tuberculosis annually, and 1.3 million are estimated to have latent TB infection (LTBI).

One of the largest clinics of its kind in Canada, the St. Michael’s TB clinic is a specialized clinic caring exclusively for individuals with suspected or diagnosed active TB and LTBI. The multidisciplinary team sees approximately 2,200 patients each year, while assessing and developing a diagnostic and management plan for up to 800 new patients each year.