❤️ HEART Score (Chest Pain)
UseStratify short-term MACE risk in ED chest pain.
Strata4–6 intermediate (observe/further testing);7–10 high risk. [Pending update] Some thresholds, grades and manag…
LimitsUse with serial troponin and ongoing clinical reassessment. · Does not replace immediate STEMI recognition and activation. · Local HEART Pathway cutoffs may differ — follow institutional protoco…
SourceSix AJ, et al. Neth Heart J 2008
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
- Who it is for
- Adults with emergency chest pain when deciding observation, rule-out, or ACS.
- Who it is not for
- Chest pain already clearly non-cardiac. No new ECG score.
- Formula and variables
- HEART is history, ECG, age, risk factors, and troponin. GRACE is age, heart rate, systolic pressure, creatinine, Killip, arrest, ST shift, and marker; the variant stays as on this page. TIMI and TIMI STEMI both exist; this page does not pick a new variant. Killip is pump class. No new chest-pain score.
- Result → next step
- Low risk stays with this page’s rule-out or observation. Once ACS is established, the next page is reperfusion and antithrombotic care. Bleeding uses CRUSADE. Stent duration uses the DAPT page. No loading dose is written.No numeric dose until age, weight, renal function, and pregnancy are all known. Pregnancy is contraindication or caution only.ACS reperfusion / antithrombotic →
- Guideline
- 2023 ESC ACS
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Methodology · worked example, guidelines & full notes
Outperforms TIMI/GRACE for undifferentiated ED chest pain.
When to use
Stratify short-term MACE risk in ED chest pain.
How it works
History, ECG, Age, Risk factors, Troponin each 0–2.
Key points
- Outperforms TIMI/GRACE for undifferentiated ED chest pain.
- Best used as the HEART Pathway with serial high-sensitivity troponin.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| History | Moderately suspicious (1) |
|---|---|
| ECG | Non-specific repolarisation (1) |
| Age | 45–64 (1) |
| Risk factors | 1–2 (1) |
| Troponin | 1–3× normal (1) |
→HEART5/10
- Risk：Moderate risk (study: 20.3%; Six 2008, PMID 18665203, n=120)
- Disposition：Admit/observe; consider early invasive evaluation if high.
| History | Slightly suspicious (0) |
|---|---|
| ECG | Normal (0) |
| Age | < 45 (0) |
| Risk factors | None (0) |
| Troponin | ≤ normal limit (0) |
→HEART0/10
- Risk：Low risk (study: 6-week MACE 2.5%; Six 2008, PMID 18665203, n=120)
- Disposition：Disposition [Pending update]
Verification & sources · governance
FAQ
Frequently asked questions
- Does HEART Score (Chest Pain) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is HEART Score (Chest Pain) calculated in practice? Can you show a worked example?
- Inputs: History Moderately suspicious (1), ECG Non-specific repolarisation (1), Age 45–64 (1), Risk factors 1–2 (1), Troponin 1–3× normal (1) → Result: HEART 5 /10（Risk: Moderate risk (study: 20.3%; Six 2008, PMID 18665203, n=120), Disposition: Admit/observe; consider early invasive evaluation if high.） Inputs: History Slightly suspicious (0), ECG Normal (0), Age < 45 (0), Risk factors None (0), Troponin ≤ normal limit (0) → Result: HEART 0 /10（Risk: Low risk (study: 6-week MACE 2.5%; Six 2008, PMID 18665203, n=120), Disposition: Disposition [Pending update]）