Centre for Cardiac Risk in the Young Persons (CRYP)

Contact Names/Numbers/Email Addresses

Main reception01 414 3058
Nurses office01 414 2723
Exercise stress room01 414 2720

Useful links

www.cry.ie (the website of the CRY charity)
www.irishheart.ie (the website of the Irish Heart Foundation)
www.heart.org (the website of the American Heart Association, which gives good information about the various heart conditions)
www.cardiomyopathy.org (formerly the Cardiomyopathy Association – a UK site which gives useful information about the inherited cardiomyopathies)
www.sads.org.uk (the UK website that gives information for families affected by sudden cardiac death, especially if it is due to sudden arrhythmic death syndrome or SADS).

Description of Department/Service

The Centre for Cardiac Risk in Younger Persons (CRYP) opened in a dedicated clinic in Tallaght University Hospital in November 2008. CRYP was developed as an inherited cardiac conditions service, and despite the name, there is no upper age limit for our patients, we see anyone with, or possible at risk of having an inherited cardiac condition.

Patients are usually referred either by their GP or another Consultant because they may have a cardiac condition themselves, or there is a history in the family which suggests there may be an inherited condition in the family (for example, a family who is affected by sudden cardiac death in a young person, or a close relative has been diagnosed with a heart muscle or electrical problem that can be hereditary). 

Conditions that we test for and manage include cardiomyopathy (heart muscle conditions) including Hypertrophic Cardiomyopathy (HCM or HOCM or even HOKUM) where the heart muscle grows thicker than normal, Dilated Cardiomyopathy (DCM) where the heart is enlarged and doesn’t pump as well as it should, or Arrhythmogenic Cardiomyopathy (previously known as ARVC or ARVD) where people develop scarring in the heart which can cause rhythm problems or pump function problems. We also test for electrical conditions such as Long QT syndrome (previously known as Romano-Ward Syndrome), Brugada Syndrome, and Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). These are all conditions where a fault in the electrical channels in the cells in the heart can cause an abnormal pattern on the ECG (see below), and can cause rhythm abnormalities (such as palpitations, blackouts or sudden death).

We also see some patients and families with premature heart attacks (due to coronary disease, also known as hardening of the arteries, or blockages in the blood vessels). This can be due to genetic problems with cholesterol (familial hyperlipidaemia), where people can have a genetic problem that means that their cholesterol levels are extremely high (maybe over 10, where normal is usually less than five), and this can cause people to have heart attacks in their 30’s and 40’s, even if they don’t smoke or have any other risk factors.

We also see patients where heart problems can occur as part of a genetic syndrome affecting other parts of the body, especially the nervous system. These would include Freidreich’s Ataxia, Muscular Dystrophies and Myotonic Dystrophies. Where possible we carry out cardiac investigations for these patients when they attend other services as part of a multi-disciplinary team.

While most of our patients are one years of age and older, we also run a Family Clinic with our Paediatric Cardiology Colleagues (Dr. David Coleman and Dr. Terry Prendiville) where children of all ages can be seen together with their parents and older family members.

A number of tests are performed on the day, which include an ECG, Echo, Exercise test (or Stress Test) and a Holter monitor (see below where each is described in more detail).

Further testing including genetic tests, MRIs or medication tests can be arranged by the Consultant if required. Each patient is also assessed by a Doctor and test results are given on the same day where possible.

The Centre is currently being funded almost entirely by direct private donations or donations to the charity Cardiac Risk in the Young (CRY – Ireland).The Centre has also been generously supported by the Adelaide Society, the Meath Foundation, The National Children’s Hospital Foundation and the Tallaght University Hospital Coffee Shop Volunteers.

Full-time staff at the Centre include the Cardiologist, a Clinical Nurse Specialist, an Administrator and one or two Cardiac Technicians who will perform your tests and answer any questions you may have on the day.

CRY-Ireland provide counselling services where appropriate (both for bereavement support, or helping to adjust to being diagnosed with a heart condition). This can be arranged by contacting the charity (www.cry.ie for further details), or you can discuss with the staff on the day you attend for your appointment.

Access to the service is by referral from another doctor (GP or Consultant usually). There is no charge for the services provided and we accept referrals from anywhere in the country. Letters of referral can be sent to Dr. Deirdre Ward, care of The Cardiac Department in Tallaght University Hospital for the attention of Dr. Ward. We can also be contacted at 01 414 3058 or by email at CDYPclinic@tuh.ie

Patient Information

You have been referred to this service by your doctor either because there is a history in your family of heart conditions that may be inherited (runs in families), or because you have been having symptoms that may be related to a heart condition. In some cases you may already have been diagnosed with a heart muscle condition (cardiomyopathy) or electrical disorder (eg Long QT syndrome or Brugada syndrome) and we have been asked to advise on your treatment. If you have a family history of sudden cardiac death and want to be screened you can ask your GP for a referral. If you need any further information you can call the centre on 01 414 3058.

Who will I meet?

Cardiologist, who is an experienced doctor specialising in inherited cardiovascular disease.
Dr. Deirdre Ward (Consultant Cardiologist) and and Dr. Derek Crinion (Consultant Cardiologist & Electrophysiologist)  
Clinical Nurse Specialists, who are experienced cardiac nurse specialising in inherited cardiovascular disease. Helen Connaughton, Rita Kinsella (sudden cardiac death nurse specialists), Ciara Barry and Laura Doorley (paediatric nurse specialists)
Cardiac Physiologist, who carry out tests such as echocardiograms (echos) and exercise testing Mark Russell (chief 1), Giedrius Michalauskas and Rachel Morgan
Administrative support staff, who organise clinic appointments, maintain medical records and type up reports from the other team members.
Deborah Blackburn and Chris O Connor 

Registrar, a senior Doctor in Training who is specialising in Cardiovascular disease and possibly Research.

What tests may I have done?

You may require some or all of these tests and they will be explained to you on the day

  1. Electrocardiogram (ECG, or in the USA it is called EKG). This is a tracing of the electrical activity in the heart. It is done by placing 10 ‘electrodes’ (stickers) on the wrists, ankles and across the left chest, attaching wires to the stickers and recording the electrical activity which is printed onto paper. No electricity is passed to the patient. The test takes about five minutes from start to finish, and the only discomfort can be in removing the ‘stickers’ at the end.

  2. Echocardiogram (ECHO). This is an ultrasound scan of the heart. This is done to look for heart muscle problems, holes in the heart, leaky valves and to measure the pump function of the heart. If you have been told you have a murmur, this is often the best test to see if this is an important murmur or an ‘innocent’ murmur. You lie (often on your side) on an examination couch and we use a cold jelly on the tip of a ‘’probe’ which is pressed against the chest to take pictures of the heart. This is very similar to the scan that pregnant women get of their babies, and even can make similar noises from time to time. The test can take anything from 15-30 minutes to perform. It should not be uncomfortable, just sometimes it is hard to lie still for the duration of the test.

  3. Exercise stress test. For this test we attach the same stickers and wires for the ECG as above, and then we get you to either walk on the treadmill or cycle an exercise bike while we watch your heart tracing. The treadmill gets a bit faster and steeper every 2-3 minutes, which gets your heart pumping quite fast, but most people don’t need to run to give us the information we need. On the bike the same effect is achieved by making the pedals stiffer every 2- 3 minutes. This helps us to look for any signs of reduced blood supply to heart muscle due to coronary artery disease (blockages or hardening of the arteries), and also can help bring on some changes associated with some of the electrical conditions such as Long QT and CPVT. We also monitor your blood pressure carefully while you exercise. We ask you to does much exercise as you feel comfortable with so we can see how your heart acts when put under a little pressure. Most people exercise between four and 12 minutes. We continue to monitor your heart as you recover for five to 10 minutes. This complete test takes approximately 20 to 30 minutes.

  4. 24-hour ECG (or Holter) uses a small box the size of a mobile phone, from which three or five leads (wires) are attached by sticky pads to your chest. The ECG monitor continuously records the heartbeat over 24 – 48 hours. Sometimes, if you have reported symptoms of palpitations or change in your heart beat, we may give you a monitor that you wear for six days (we give you extra stickers so that you can take them off to wash). Depending on where you live, we either ask you to drop the monitor back into us, or else post it back to us by registered post.

What do I need to bring?

We may also need to do additional tests such as blood tests and sometimes we will need a chest x-ray. If you may need fasting blood tests, we will usually have mentioned that on your appointment card. If you are unsure about anything before your appointment, and wish to enquire, please phone Debbie on 01 414 3058 or email CDYPClinic@tuh.ie

How do I get there?

Comfortable clothing and shoes should be worn as you may be required to do an Exercise Stress Test. Shower facilities are available if required.

Further information

The CRY Centre is no longer located on the TUH Campus, it is across the road from the main entrance to the Hospital at Tallaght Cross West. 

There are a number of car parking options around the CRY Centre including the underground car park of Tallaght Cross / Aldi. There is also parking available in The Square Shopping Centre, which is withing walking distance of the CRY Building.

Directions from the Luas
On exiting the Luas at the TUH stop, while facing the Hospital turn right. Walk to the lights and cross the pedestrian crossing and turn left and down Cookstown Way. The CRY building is situated on the right hand side. 

If you require any further information you can contact the centre on 01 414 3058, email CDYPClinic@tuh.ie or see our information leaflet on this website