HEART Score - Chest Pain Risk Stratification
Stratify risk of major adverse cardiac events (MACE) in patients presenting with chest pain using the HEART Score.
Important Medical Disclaimer
This calculator is an educational and clinical decision support tool. Results DO NOT replace professional medical evaluation, laboratory tests, or clinical judgment. Always consult a qualified healthcare professional for diagnosis, treatment, and clinical decisions. Calculations are based on scientifically validated formulas but may not be applicable to all patients.
About HEART Score
The HEART Score is a validated clinical decision rule used to risk stratify patients presenting to the emergency department with chest pain. It helps identify patients at low risk for major adverse cardiac events (MACE) who may be suitable for early discharge.
HEART Score Components
- H - History (0-2 points): Assess how suspicious the chest pain history is for ACS
- E - ECG (0-2 points): Evaluate ECG findings
- A - Age (0-2 points): Patient age as a risk factor
- R - Risk factors (0-2 points): Traditional cardiovascular risk factors
- T - Troponin (0-2 points): Initial troponin level
Score Interpretation
- 0-3 points: Low risk (1.7% MACE) - Consider early discharge with outpatient follow-up
- 4-6 points: Moderate risk (12% MACE) - Admit for observation and further workup
- 7-10 points: High risk (65% MACE) - Early invasive strategy recommended
MACE Definition
Major Adverse Cardiac Events (MACE) typically includes: acute myocardial infarction (AMI), percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), significant coronary stenosis managed conservatively, and death from any cause within 6 weeks.
Note: The HEART Score should be used in conjunction with clinical judgment. It is designed for patients presenting with chest pain in the emergency department and may not be appropriate for all patient populations. Serial troponins and clinical reassessment remain important components of chest pain evaluation.
References
- Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008;16(6):191-196.
- Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013;168(3):2153-2158.
- Mahler SA, Riley RF, Hiestand BC, et al. The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge. Circ Cardiovasc Qual Outcomes. 2015;8(2):195-203.