HEART Score

Clinical Use

Risk stratification for patients presenting with chest pain in the emergency department

Information

The HEART score is a scoring system for patients presenting with chest pain in the emergency department. By assigning patient history, ECG, age, risk factors, and troponin, patients receive a score on a scale of 0‒10.

VariableScore
HistoryHighly suspicious2
Moderately suspicious1
Slightly suspicious0
ECGSignificant ST depression2
Nonspecific repolarisation disturbance1
Normal0
Age≤65 year2
45-65 year1
<45 year0
Risk factors≥3 risk factors or history of atherosclerotic disease2
1 or 2 risk factors1
No risk factors known0
Troponin>2x normal2
1-2x normal1
Normal0

 

* Risk factors include hypercholesterolemia, hypertension, diabetes mellitus, cigarette smoking, positive family history, obesity (BMI >30).

Risk stratification is determined by patient’s total score.

Scores 0-3: Low risk with 0.9-1.7% risk of 6-week MACE**. Recommend discharge with PCP follow-up.

Scores 4-6: Moderate risk with 12-16.6% risk of 6-week MACE**. Recommend admission to Observation for further evaluation OR if negative troponin at 0 and 3 hrs, order outpatient stress test.

Scores ≥7: High risk with 50-65% risk of 6-week MACE**. Recommend admission for inpatient evaluation and cardiology consultation.

** MACE (Major Adverse Cardiac Event) is defined as all-cause mortality, myocardial infarction, or coronary revascularization.

References

1.Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008;16(6):191-6. Abstract

Disclaimer

We are doing our best to prepare the content of this website. However, Cardiology Connections, Corp cannot warranty the expressions and suggestions of the contents, as well as its accuracy. In addition, to the extent permitted by the law, Cardiology Connections, Corp shall not be responsible for any losses and/or damages due to the usage of the information on our website. Furthermore, the links contained on our website may lead to external sites, which are provided for convenience only. Any information or statements that appeared in these sites are not sponsored, endorsed, or otherwise approved by Cardiology Connections, Corp. For these external sites, Cardiology Connections, Corp cannot be held liable for the availability of, or the content located on or through it. Plus, any losses or damages occurred from using these contents or the internet generally.

Developer: Sirikarn Napan, MD, FACC