HEART Score Calculator
Assess chest pain risk and predict major adverse cardiac events (MACE)
HEART Score Assessment
The HEART score helps assess the risk of major adverse cardiac events (MACE) in patients with chest pain.
Age
History
Clinical presentation and symptoms
ECG Findings
12-lead electrocardiogram results
Risk Factors
Select all that apply to the patient
Risk factors count: 0
Initial Troponin
Compare with laboratory normal ranges
HEART Score Results
Score Breakdown
Clinical Recommendation
Suitable for early discharge. Low risk of MACE within 6 weeks.
Example Patient Case
Patient: 71-year-old Male with Chest Pain
Age: 71 years (≥65)
History: Mixed elements of typical and atypical ACS symptoms
ECG: Abnormal with known changes, no significant ST deviation
Risk Factors: Diabetes and hypertension (2 factors)
Troponin: Elevated 1.5 times normal
HEART Score Calculation
H - History (mixed): 1 point
E - ECG (abnormal, no ST): 1 point
A - Age (71 years): 2 points
R - Risk factors (2 factors): 1 point
T - Troponin (1.5x elevated): 1 point
Total HEART Score: 6 (Moderate Risk, 12-17% MACE risk)
Risk Categories
Low Risk (0-3)
≤1.7% MACE risk
Early discharge suitable
Moderate Risk (4-6)
12-17% MACE risk
Further testing needed
High Risk (7-10)
50-65% MACE risk
Urgent intervention
HEART Acronym
What is MACE?
Major Adverse Cardiovascular Events within 6 weeks include:
All-cause mortality
Acute myocardial infarction (AMI)
Percutaneous coronary intervention (PCI)
Coronary artery bypass graft (CABG)
Understanding the HEART Score
Purpose and Application
The HEART score is a validated clinical decision rule for risk stratification of patients presenting with chest pain in the emergency department. It helps identify patients at low risk for major adverse cardiac events (MACE) within 6 weeks.
Clinical Validation
Developed and validated in multiple studies, the HEART score has been shown to effectively stratify chest pain patients, allowing for safe early discharge of low-risk patients while identifying high-risk patients requiring immediate intervention.
Key Principles
Important Considerations:
- • Should not be used in patients with known ACS
- • Designed for emergency department chest pain evaluation
- • Predicts 6-week MACE risk, not immediate outcomes
- • Must be combined with clinical judgment
Important: This score should not replace comprehensive clinical assessment and should only be used in appropriate clinical settings by qualified healthcare providers.
Clinical Decision Making
Low Risk (0-3)
Consider early discharge with appropriate follow-up. Serial troponins may not be necessary.
Moderate Risk (4-6)
Further cardiac evaluation required. Consider observation, serial biomarkers, and stress testing.
High Risk (7-10)
High MACE risk requires urgent cardiology consultation and immediate intervention consideration.
Score Components Explanation
History Assessment
- • Non-suspicious: Atypical chest pain, unlikely cardiac
- • Moderately suspicious: Some typical ACS features
- • Highly suspicious: Classic ACS presentation
ECG Interpretation
- • Normal: No acute changes
- • Non-specific abnormal: Old changes, no acute ST changes
- • Significant ST deviation: New or unknown ST changes
Related Cardiovascular Risk Calculators
Important Medical Disclaimer
This HEART Score Calculator is designed for educational purposes and clinical reference only. It should never replace comprehensive clinical assessment or professional medical judgment in emergency department settings.
Healthcare professionals should:
- Use HEART score only in appropriate clinical contexts (chest pain without known ACS)
- Combine results with comprehensive clinical assessment
- Consider institutional protocols and guidelines
- Follow current emergency medicine and cardiology guidelines
- Never use as sole basis for discharge or admission decisions
- Ensure appropriate follow-up for all risk categories
This tool is based on validated research and should be used in conjunction with current evidence-based guidelines for acute chest pain evaluation and management.