- The score has been derived and validated in an ED population and predicts 6 week adverse cardiac events
- Low risk patients have a score 0-3 and have a less than 2% risk of MACE at 6 weeks.
|ST deviation not due to LBBB, LVH, or digoxin||+2|
|No ST deviation but LBBB, LVH, or repolarization changes||+1|
|Risk Factors (Hypercholesterolemia, Vascular Disease, Hypertension, Diabetes Mellitus, Smoking,Obesity)|
|≥ 3 risk factors or history of atherosclerotic disease||+2|
|1-2 risk factors||+1|
|No risk factors known||0|
|≥ 3× normal limit||+2|
|1-3× normal limit||+1|
|≤ normal limit||0|
- 0-3: 0.9-1.7% risk of adverse cardiac event. Patient's can be discharged with follow-up.
- 4-6: 12-16.6% risk of adverse cardiac event. Patients should be admitted to the hospital for trending of troponin and provocative testing.
- ≥7: 50-65% risk of adverse cardiac event, suggesting early invasive measures with these patients and close coordination with inpatient cardiology
- Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008 Jun;16(6):191-6.PMID 18665203
- Backus BE, Six AJ, Kelder JC, Bosschaert MA. et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013 Oct 3;168(3):2153-8 PMID 2346525
- Ljung L et al. A rule-out strategy based on high-sensitivity troponin and HEART score reduces hospital admissions. Ann Emerg Med 2019 Jan 17; [e-pub].
- Stopyra JP, Riley RF, Hiestand BC, et al. The HEART Pathway Randomized Controlled Trial One Year Outcomes. Acad Emerg Med. 2018
- 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.