HEART Score for ED Chest Pain

Summary

The HEART score is a validated 5-component tool used in emergency departments to risk-stratify patients presenting with chest pain for major adverse cardiac events (MACE) within 30 days. Each component — History, ECG, Age, Risk factors, and Troponin — is scored 0 to 2, giving a total of 0–10. Low scores support early discharge, while high scores indicate urgent cardiac evaluation.

How it works

1. Select the descriptor that best matches the patient's History of chest pain presentation.
2. Choose the ECG finding most consistent with the current tracing.
3. Pick the Age band that applies to the patient.
4. Count and select the number of active cardiac Risk factors.
5. Choose the initial Troponin result relative to your lab's normal limit.
6. 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.

Frequently Asked Questions