EXPLODING BACTERIAMed Decision Speed Tools
ED Decision Tools

HEART Score for Chest Pain

Assesses the short-term risk of Major Adverse Cardiac Event (MACE) in next 6 weeks in patients presenting with chest pain, guiding decisions about admission, further testing, or early discharge

Low risk
HEART 0–3 · MACE ~0.9–1.7% at 6 weeks
Below the test threshold — discharge with follow-up is reasonable
0pts
History — pattern, onset, duration, relation to exertion, localization, response to nitrates
ECG — compare with a prior if available
Age
Risk factors — diabetes, hypertension, current smoking, hyperlipidaemia, family history of CAD, obesity (BMI >30)
Troponin — against your institution's reference range
Six AJ, et al. 2008 · Built for UNDIFFERENTIATED ED chest pain — unlike TIMI/GRACE, which were derived in populations already known to have ACS. STEMI is managed separately — do not score it. A single normal ECG is only ~50% sensitive for NSTEMI; serial ECGs and a troponin trend beat any single value.