Clinical Resources

HEART Score

Risk Stratification for Chest Pain in the Emergency Department

Select one option per category. Each category is scored 0–2; total score 0–10.

H History —
E ECG —
A Age —
R Risk Factors —
T Troponin —
HEART Score
Select all 5 categories
—  / 10

Scoring Guide

  • History — Highly suspicious: typical chest pressure radiating to arm/jaw, diaphoresis, relief with nitrates. Slightly suspicious: musculoskeletal/GI/pleuritic features or poorly described pain.
  • ECG — Significant ST deviation: new horizontal/downsloping ST depression ≥0.5 mm or T-wave inversion in ≥2 contiguous leads.
  • Risk factors — HTN, hypercholesterolemia, diabetes, obesity (BMI >30), current/recent smoking (<90 days), positive family history (1st-degree relative with CAD <65 F / <55 M).
  • Troponin — Expressed as multiples of the 99th percentile upper reference limit (URL) for the assay used.

For clinical decision-making only. The HEART Score is intended as a decision aid, not a replacement for clinical judgment. MACE = major adverse cardiac events (MI, PCI/CABG, death) within 6 weeks.

Reference

Backus BE et al. (2013) — A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 168(3):2153–8.