About the Research

Use the Scale

We created this scale because…

Over 16,000 Canadians die each year from unrecognized warning signs of a heart attack. This alone accounts for 29% of all deaths in Canada each year. 49-92% of people experience warning signs but do not recognize them as warning signs of a heart attack because they occur at unusual times and are totally unexpected.

Warning signs, or Prodromal Symptoms are described as unusual or unexpected symptoms that come and go, so they are hard to recognize, because they change in level of severity and frequency and can happen days, weeks, or months before a heart attack. Sometimes two or three symptoms can happen at a time. Some examples of prodromal symptoms include: chest pain/tightness, heaviness, discomfort, dizziness, shortness of breath, nausea, fatigue, anxiety, or headaches.

The Prodromal Symptoms-Screening Scale (PS-SS) was developed to alert people to the warning signs of heart disease. Women and men with known heart disease and health care providers who have expertise in cardiovascular health care assisted in the development of this tool. It has been previously used and tested by individuals with heart disease and is reliable and valid.

The PS-SS has the potential to “get ahead of heart disease” by increasing your knowledge of warning signs and screening for them annually. The PS-SS also provides Healthcare Providers with a tool to identify your prodromal symptoms and individual risk factors and manage your heart health.

The Cardiac Prodromal Symptoms Educational Strategy Team

This innovative research team brings together recognized collaborators and researchers with requisite expertise in cardiac prodromal symptom presentation (O’Keefe-McCarthy) cardiac pain (O’Keefe-McCarthy, Keeping-Burke); cardiovascular/adult education (Boyd, Gibson); educational strategy uptake and education (Taplay), design, discover, deliver methodology (Chalmers/Levy), qualitative analysis (Taplay), statistical analysis (McPherson), knowledge translation (Keeping-Burke, O’Keefe-McCarthy), clinical experts in cardiovascular medicine and nursing (Boyd, O’Keefe-McCarthy, Keeping-Burke), and advocates for community-based health services, public education and health promotion (Stearne, Gibson [Heart Niagara] and advocacy of prevention of cardiovascular disease and education about cardiac health across Canada (Kennedy, Sawdon [Cardiac Health Foundation of Canada).

  • Sheila O'Keefe-McCarthy Sheila O'Keefe-McCarthy, RN, PhD

    Assistant Professor, Brock University Department of Nursing

    Ontario Research Chair-Canadian Council of Cardiovascular Nurses-National Research Committee

  • Lisa Keeping-Burke Lisa Keeping-Burke, RN, PhD

    Associate Dean of Health Research

    Associate Professor, Department of Nursing & Health Sciences, UNB

    Adjunct Professor, School of Nursing, Queen's University

  • Karyn Taplay Karyn Taplay, RN, PhD

    Associate Professor, Brock University Department of Nursing

  • Ian Chalmers Ian Chalmers

    Creative Director, Principle Pivot Design Group

  • Lauren Levy Lauren Levy

    Senior User Experience Designer Pivot Design Group

  • Collaborators
    • Karen Stearne, BSc
    • Don Gibson, NP-PHC
    • Barbara Kennedy, BA, B.Ed, MA
    • John Sawdon, M.Sc
    • Lisa Boyd, RN BScN CCN(C)
      MSc (Nursing)


  • Canadian Council of Cardiovascular Nurses / Conseil canadien des infirmières(iers) en nursing cardiovasculaire
  • Cardiac Health Foundation Of Canada
  • Heart Niagara
  • Brock University
  • Sheila O'Keefe-McCarthy - Heart Innovation Research Program
  • Pivot Design

Funded by

Women's College Hospital - Women's Xchange