HEART Score

Risk stratification for ACS in ED chest pain patients

Indication

id: history; label: History; type: options; options: label: Slightly suspicious; value: 0; label: Moderately suspicious; value: 1; label: Highly suspicious; value: 2
id: ecg; label: ECG; type: options; options: label: Normal; value: 0; label: Non-specific repolarization abnormality; value: 1; label: Significant ST deviation; value: 2
id: age; label: Age; type: options; options: label: < 45; value: 0; label: 45–64; value: 1; label: ≥ 65; value: 2
id: risk; label: Risk Factors; type: options; options: label: No known risk factors; value: 0; label: 1–2 risk factors; value: 1; label: ≥ 3 risk factors or history of atherosclerotic disease; value: 2
id: troponin; label: Troponin; type: options; options: label: ≤ normal limit; value: 0; label: 1–3× normal limit; value: 1; label: > 3× normal limit; value: 2

function(score) { if (score <= 3) return { risk: score + '/10', tier: 'Low Risk', action: '1.7% MACE at 6 weeks. Consider discharge with outpatient follow-up.', color: 'green' }; if (score <= 6) return { risk: score + '/10', tier: 'Moderate Risk', action: '12–16.6% MACE at 6 weeks. Admit for observation and serial troponins.', color: 'yellow' }; return { risk: score + '/10', tier: 'High Risk', action: '50–65% MACE at 6 weeks. Early invasive strategy — cardiology consult.', color: 'red' }; }

HEART ≤3 with negative serial troponins — safe for discharge with outpatient follow-up
Risk factors: HTN, hyperlipidemia, DM, obesity (BMI >30), smoking, family history, prior atherosclerotic disease
Do NOT apply to STEMI — those patients need immediate cath regardless of score

Backus et al., Crit Pathways in Cardiology 2010; Six et al., Int J Cardiol 2013. Last reviewed: 2024-10-01