❤️ HEART Score (Chest Pain)
Risk-stratify emergency department chest pain with the HEART score.
Clinical takeaway
Outperforms TIMI/GRACE for undifferentiated ED chest pain.
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When to use
Identify low-risk chest pain suitable for early discharge.
How it works
History, ECG, Age, Risk factors, Troponin each 0–2. 0–3 low, 4–6 moderate, 7–10 high risk of 6-week MACE.
Key points
- Outperforms TIMI/GRACE for undifferentiated ED chest pain.
- Best used as the HEART Pathway with serial high-sensitivity troponin.
- Low score (0–3) supports early discharge with follow-up.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| History | Slightly suspicious (0) |
|---|---|
| ECG | Normal (0) |
| Age | < 45 (0) |
| Risk factors | None (0) |
| Troponin | ≤ normal limit (0) |
→HEART0/10
- Risk：Low risk (~1.7% 6-week MACE)
- Disposition：Consider early discharge with outpatient follow-up (with serial troponin per pathway).
| History | Highly suspicious (2) |
|---|---|
| ECG | Significant ST deviation (2) |
| Age | ≥ 65 (2) |
| Risk factors | ≥ 3 or known atherosclerosis (2) |
| Troponin | > 3× normal (2) |
→HEART10/10
- Risk：High risk (~50.1%)
- Disposition：Admit/observe; consider early invasive evaluation if high.
Frequently asked questions
- What is HEART Score (Chest Pain)?
- Risk-stratify emergency department chest pain with the HEART score.
- How is HEART Score (Chest Pain) calculated? What is the core formula?
- History, ECG, Age, Risk factors, Troponin each 0–2. 0–3 low, 4–6 moderate, 7–10 high risk of 6-week MACE.
- When is HEART Score (Chest Pain) used?
- Identify low-risk chest pain suitable for early discharge.
- What are the key clinical points for HEART Score (Chest Pain)?
- Outperforms TIMI/GRACE for undifferentiated ED chest pain. Best used as the HEART Pathway with serial high-sensitivity troponin. Low score (0–3) supports early discharge with follow-up.
- What are the limits and cautions when using HEART Score (Chest Pain)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is HEART Score (Chest Pain) calculated in practice? Can you show a worked example?
- Inputs: History Slightly suspicious (0), ECG Normal (0), Age < 45 (0), Risk factors None (0), Troponin ≤ normal limit (0) → Result: HEART 0 /10（Risk: Low risk (~1.7% 6-week MACE), Disposition: Consider early discharge with outpatient follow-up (with serial troponin per pathway).） Inputs: History Highly suspicious (2), ECG Significant ST deviation (2), Age ≥ 65 (2), Risk factors ≥ 3 or known atherosclerosis (2), Troponin > 3× normal (2) → Result: HEART 10 /10（Risk: High risk (~50.1%), Disposition: Admit/observe; consider early invasive evaluation if high.）