Chest pain accounts for nearly one million emergency department (ED) visits annually in Canada, and distinguishing serious heart problems from trivial diagnoses can be a challenging procedure. As a cardiac referral center, St Paul’s Hospital manages many such patients. Our research has emphasized safe, rapid discharge of patients that might previously have been admitted to hospital. We have demonstrated that many tests that were traditionally conducted in hospital can be deferred to outpatient environments, decreasing ED resource use while maintaining safety. Finally, our team has shown that cardiac computed tomography, (CT) a new technology, is both safe and effective in diagnosing heart disease.

Selected publications.

Humphries K, Lee M, Izadnegahdar M, Gao M, Holmes DT, Scheuermeyer FX, Mackay MM, Mattman M, Grafstein E. Sex Differences in Diagnoses, Treatment and Outcomes for Emergency Department Patients with Chest Pain and Elevated Cardiac Troponin. Acad Emerg Med. 2018. In press.

Al-Mohassain MA, Carere R, Mancini J, Humphries K, Whalen B, Lee T, Scheuermeyer FX, Ignaszewski A. A Plaque Disruption Index Identifies Patients with Non-STE-Type 1 Myocardial Infarction within 24 Hours of Troponin Positivity. PLOS One. 2016 Oct 6;11(10):e0164315.

Flaws D, Than M, Scheuermeyer FX, Christenson J, Boychuk B, Parsonage W, Aldous S, Greenslade J, Cullen C. External Validation of the Emergency Department Assessment of Chest pain Score Accelerated Diagnostic Pathway (EDACS-ADP). Emerg Med J. 2016. 33; 618 – 625

Grunau BE, Leipsic J, Purssell E, Kasteel N, Nguyen K, Kazem M, Nauom C, Raju R, Blanke P, Heilbron B, Taylor C, Scheuermeyer FX. Comparison of Rates of Coronary Angiography and Combined Testing Procedures in Patients Seen in the Emergency Room with Chest Pain (But no Objective Acute Coronary Syndrome Findings) Having Coronary Computed Tomography versus Exercise Stress Testing. Am J Cardiol. 2016; 118: 155 – 161.

Scheuermeyer FX, Grunau B, Raju R, Choy S, Naoum C, Blanke P, Hague C, Heilbron B, Taylor C, Kalla D, Christenson J, Innes G, Hanakova M, Leipsic J. Safety and efficiency of outpatient versus emergency department-based coronary CT angiography for evaluation of patients with potential ischemic chest pain. J Cardiovasc Comput Tomogr. 2015; 9: 534 – 37

Scheuermeyer FX, Grunau BE, Findlay T, Grafstein E, Christenson J, Rowe B, Lang E, Ho K. Speed and accuracy of text-messaging emergency department electrocardiograms from a small community hospital to a provincial referral center. J Telemed Telecare. 2016; 22: 105 – 113.

Scheuermeyer FX, Wong H, Yu E, Boychuk B, Innes G, Grafstein E, Gin K, Christenson J. Development and validation of a prediction rule for early discharge of low-risk emergency department patients with potential ischemic chest pain. CJEM. 2014; 16: 106 – 19.

Brunner NW, Scheuermeyer FX, Grafstein E, Ramanathan K. Outcomes of non-acute coronary syndrome patients discharged from the emergency department with troponin positivity. CJEM. 2014; 16: 41 – 52.

Scheuermeyer FX, Innes G, Grafstein E, Kiess M, Boychuk B, Yu E, Kalla D, Christenson J. Safety and efficiency of a chest pain diagnostic algorithm with selective outpatient stress testing for emergency department patients with potential ischemic chest pain. Ann Emerg Med. 2012; 59: 256 – 264.e3

Scheuermeyer FX, Christenson J, Innes G, Boychuk B, Yu E, Grafstein E. Safety of assessment of patients with potential ischemic chest pain in an emergency department waiting room: a prospective comparative cohort study. Ann Emerg Med, 2010; 56: 455-62