Electronic health records (EHRs) serve as a digital repository storing comprehensive medical information about patients. Representation learning for EHRs plays a crucial role in healthcare applications. In this paper, we propose a Multimodal Heterogeneous Graph-enhanced Representation Learning, denoted as MHGRL, aimed at learning effective EHR representations. To address the challenge posed by data insufficiency of EHRs, MHGRL utilizes a multimodal heterogeneous graph to model an EHR. Specifically, we construct a heterogeneous graph for each EHR and enrich it by incorporating multimodal information with medical ontology and textual notes. With the integration of pre-trained model, graph neural network, and attention mechanism, MHGRL effectively incorporates both node attributes and structural information across a multimodal heterogeneous graph. Moreover, we employ contrastive learning to ensure the consistency of representations for similar EHRs and improve the model robustness. The experimental results show that MHGRL outperforms all baselines on two real clinical datasets in downstream tasks, including EHR clustering and disease prediction. The code is available at https://github.com/emmali808/MHGRL.