Grant: Doctoral: Vanier Canada Graduate Scholarships

The correct identification and diagnosis of cardiovascular disease (CVD) is one of the biggest challenges facing physicians in the emergency department. The battery of tests currently conducted when a patient arrives with signs and symptoms of CVD has been shown to be insufficiently accurate for properly diagnosing the patient's condition. This inefficient protocol is responsible for significant increases in the risk of mortality for patients who are wrongfully discharged. One of the earliest manifestations of CVD is dysfunction of the endothelial cell layer which lines the lumen of the arteries. Yet, there is no efficient test of endothelial function included in the series of exams undergone by the patient upon arrival at the emergency room. We propose to investigate the usefulness of a newly developed nuclear imaging test to measure forearm blood flow in this role. This nuclear imaging test will be compared with the already established 'myocardial perfusion imaging' which quantifies any reduction in blood flow to the heart and assess what damage this may cause. Additionally, valuable patient information concerning final physician diagnosis and treatment details, clinical risk factors, demographic data and psychological characteristics will be compiled. Patients will also be followed for 30 days post emergency department visit and details of their cardiac events and mortality will be recorded. The implementation of this technique in a regular battery of tests could be very significant in reducing unnecessary hospitalizations in addition to reducing the number of wrongfully discharged patients. Moreover, this test may also be profitable by reducing health care costs directly incurred by CVD.