HEART 评分 - 胸痛风险分层
Assess major cardiovascular event risk in chest pain patients
重要医学免责声明
本计算器是教育和临床决策支持工具。结果不能替代专业医学评估、实验室检查或临床判断。诊断、治疗和临床决策请务必咨询合格的医疗保健专业人员。计算基于经科学验证的公式，但可能不适用于所有患者。
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.