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Cardiovascular
HEART Score
Risk-stratify chest pain patients in the ED for major adverse cardiac events (MACE).
When to use: Use HEART Score in the emergency department to risk-stratify undifferentiated chest pain patients and guide disposition. A score of 0–3 supports safe early discharge with a sensitivity for MACE of ~99% when combined with a negative initial troponin. It outperforms TIMI and GRACE scores in the ED chest pain context.
Calculator
Assess chest pain character, radiation, precipitants, relief
Use lab-specific reference range
Fill in all fields to see the result
Formula
HEART = History(0-2) + ECG(0-2) + Age(0-2) + Risk Factors(0-2) + Troponin(0-2)
Max score = 10
0-3 = Low (1.7% MACE), 4-6 = Moderate, 7-10 = High (>50% MACE)
Key Points for NEET PG
- HEART acronym: History, ECG, Age, Risk factors, Troponin — each scored 0/1/2.
- Score ≤3: ~1.7% MACE — safe for discharge; score 4-6: ~12% MACE — admit; score ≥7: >50% MACE — urgent cath.
- HEART score is validated specifically for ED chest pain; GRACE score is validated for risk in confirmed ACS patients.
- Troponin component uses lab-specific upper limit of normal (ULN) — high-sensitivity troponin (hs-cTnI/T) allows faster rule-out.
- Compare with TIMI (for NSTEMI/UA) and GRACE (for ACS in-hospital/6-month mortality) which are validated in different populations.
References
Six AJ et al. The HEART score for the assessment of patients with chest pain in the emergency department · Neth Heart J (2010)
Mahler SA et al. The HEART Pathway randomized trial · Circ Cardiovasc Qual Outcomes (2015)
For educational purposes only. Not for clinical decision-making without professional oversight.