Heart Pathway Score (HEART Score)
Score 5 components — History, ECG, Age, Risk factors, Troponin — to stratify chest pain patients into low, intermediate, or high MACE risk.
Educational use only. This tool is not a substitute for clinical judgment. All patient care decisions must be made by a licensed clinician.
History
How suspicious is the history for an acute coronary syndrome?
ECG
What does the 12-lead ECG show?
Age
Patient age at presentation.
Risk Factors
Known cardiovascular risk factors: hypertension, hypercholesterolemia, diabetes, obesity (BMI >30), smoking (current or stopped ≤90 days), family history of CAD, atherosclerosis.
Troponin
Initial troponin level relative to your institution's upper limit of normal (ULN).
Answer all 5 components on the left, then calculate your HEART score.
Component Breakdown
MACE rates cited from Backus et al. (2010) and subsequent validation studies. For educational use only — not a substitute for clinical judgment.
Summary
Score 5 components — History, ECG, Age, Risk factors, Troponin — to stratify chest pain patients into low, intermediate, or high MACE risk.
How it works
- Select a score (0, 1, or 2) for each of the five HEART components.
- History: how suspicious is the patient's history for an acute coronary syndrome?
- ECG: classify the ECG finding — normal, non-specific changes, or significant ST deviation.
- Age: select the patient's age bracket (<45, 45–64, or ≥65).
- Risk factors: count known cardiovascular risk factors or prior atherosclerotic disease.
- Troponin: compare the troponin value to the institutional upper limit of normal (ULN).
- The calculator sums all five components and displays the total score with risk category and estimated 6-week MACE probability.
Use cases
- Triage chest pain patients in the emergency department to identify who can be safely discharged.
- Support clinical decision-making for early discharge vs. observation or further workup.
- Educate medical students and residents on structured chest pain risk scoring.
- Document a structured risk assessment in clinical notes.