What does the HEART score stand for?

Each letter maps to one scoring component: History (0–2), ECG (0–2), Age (0–2), Risk factors (0–2), and Troponin (0–2). The five components sum to a 0–10 scale.

What are the HEART score risk categories?

Scores 0–3 indicate low risk (~2% 30-day MACE), 4–6 moderate risk (~12% MACE), and 7–10 high risk (~65% MACE). Low-risk patients may be candidates for early discharge after shared decision-making.

Is this calculator a substitute for clinical judgment?

No. The HEART score is a decision-support aid. Clinical context, serial troponins, and physician judgment must always be applied. This tool is for educational and reference purposes only.

Which troponin value should I use?

Use the first (initial) troponin drawn on arrival. Score 0 if ≤ normal limit, 1 if 1–3× normal, and 2 if > 3× normal.

What risk factors count toward the Risk Factors component?

Diabetes, current or recent tobacco use, diagnosed hypertension, hypercholesterolemia, family history of CAD, obesity (BMI > 30), and known atherosclerotic disease. A history of prior PCI, CABG, or MI also scores 2 points.

HEART Score Calculator — ED Chest Pain Risk Stratification

Summary

Score chest pain patients in the ED using the 5-component HEART score to identify low, moderate, or high MACE risk.

How it works

Select the descriptor that best matches the patient's History of chest pain presentation.
Choose the ECG finding most consistent with the current tracing.
Pick the Age band that applies to the patient.
Count and select the number of active cardiac Risk factors.
Choose the initial Troponin result relative to your lab's normal limit.
The total HEART score (0–10) and risk category appear instantly.

Use cases

Triage undifferentiated chest pain in the emergency department.
Identify low-risk patients (score 0–3) suitable for early discharge.
Flag high-risk patients (score 7–10) needing urgent cardiac workup.
Support shared decision-making when discussing admission vs. observation.
Supplement clinical judgment alongside troponin serial testing.
Document structured risk assessment for medicolegal purposes.

HEART Score for ED Chest Pain

Patient Parameters

Score Breakdown

Recommendation