maratoolHEART Score Calculator
HEART Score for major adverse cardiac events in chest pain (0–10).
References
- Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008;16(6):191-196.
- Mahler SA, Riley RF, Hiestand BC, et al. The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge. Circ Cardiovasc Qual Outcomes. 2015;8(2):195-203.
What is HEART Score?
The HEART score is an emergency-department risk stratification tool that predicts 6-week major adverse cardiac events (MACE) — death, myocardial infarction, or coronary revascularization — in patients presenting with chest pain. Developed by Six et al. in the Netherlands in 2008, it scores five domains 0–2: History, ECG, Age, Risk factors, and Troponin. The total ranges from 0 to 10. Scores 0–3 indicate low risk (~1.7% MACE) and support discharge, 4–6 moderate risk (~16.6%) warrants observation and serial troponins, and 7–10 high risk (~50%) prompts early invasive evaluation.
How to use
- Score history, ECG, age, risk factors, and troponin (0–2 each).
- The HEART score (0–10) and MACE risk update instantly.
- Use the HEART Pathway with serial troponins for safe ED disposition.
Frequently asked questions
What does HEART stand for?
History, ECG, Age, Risk factors, Troponin — a 5-domain score for 6-week risk of major adverse cardiac events (MACE) in undifferentiated chest pain.
What MACE rate is considered safe for discharge?
A HEART score 0–3 corresponds to a 6-week MACE rate of < 2%, generally accepted as safe for outpatient follow-up without admission.
HEART vs TIMI vs GRACE?
HEART has higher discrimination for undifferentiated chest pain in the ED than TIMI/GRACE (which were derived from confirmed ACS populations).
Does HEART include high-sensitivity troponin?
The original HEART used conventional troponin. Newer pathways (HEART Pathway, EDACS) integrate hs-cTn for faster rule-out.
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