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HEART Score

Prediction tool to help assess the risk of major adverse cardiac event (MACE) within the next 6 weeks. 
History
Is the clinical history suspicious for acute coronary syndrome?
EKG Changes
  • 1 point: 
    • No ST deviation but LBBB
    • LVH
    • Repol changes (e.g. digoxin); 
  • 2 points: 
    • ST deviation (not due to LBBB, LVH, or digoxin)
Age
Risk Factors
  • Hypertension
  • Hypercholesterolemia
  • Diabetes
  • Obesity (BMI >30 kg/m²)
  • Smoking (current, or smoking cessation ≤3 mo)
  • Family history (parent or sibling with CVD before age 65)
  • Atherosclerotic disease: prior MI, PCI/CABG, CVA/TIA, or PAD
Troponin
Result : 0
The patient is considered to be at moderate risk for a major adverse cardiac event and may benefit from continued work-up and management in the hospital.
The patient is considered high risk for a major adverse cardiac event and thus does not meet ED discharge criteria and will likely benefit from staying in the hospital.  
Based on my clinical assessment and the HEART Score, the patient is considered low risk for a major adverse cardiac event and thus with negative troponin is a reasonable candidate for discharge with outpatient follow-up and return precautions.  
Based on my clinical assessment and the HEART Score, the patient is considered low risk for a major adverse cardiac event and thus with negative troponin is a reasonable candidate for discharge with outpatient follow-up and return precautions.  
Based on my clinical assessment and the HEART Score, the patient is considered low risk for a major adverse cardiac event and thus with negative troponin is a reasonable candidate for discharge with outpatient follow-up and return precautions.  
The patient is considered to be at moderate risk for a major adverse cardiac event and may benefit from continued work-up and management in the hospital.
The patient is considered to be at moderate risk for a major adverse cardiac event and may benefit from continued work-up and management in the hospital.
The patient is considered high risk for a major adverse cardiac event and thus does not meet ED discharge criteria and will likely benefit from staying in the hospital.  
Based on my clinical assessment and the HEART Score, the patient is considered low risk for a major adverse cardiac event and thus with negative troponin is a reasonable candidate for discharge with outpatient follow-up and return precautions.  
Result : 0
The patient is considered to be at moderate risk for a major adverse cardiac event and may benefit from continued work-up and management in the hospital.
The patient is considered high risk for a major adverse cardiac event and thus does not meet ED discharge criteria and will likely benefit from staying in the hospital.  
Based on my clinical assessment and the HEART Score, the patient is considered low risk for a major adverse cardiac event and thus with negative troponin is a reasonable candidate for discharge with outpatient follow-up and return precautions.  
Based on my clinical assessment and the HEART Score, the patient is considered low risk for a major adverse cardiac event and thus with negative troponin is a reasonable candidate for discharge with outpatient follow-up and return precautions.  
Based on my clinical assessment and the HEART Score, the patient is considered low risk for a major adverse cardiac event and thus with negative troponin is a reasonable candidate for discharge with outpatient follow-up and return precautions.  
The patient is considered to be at moderate risk for a major adverse cardiac event and may benefit from continued work-up and management in the hospital.
The patient is considered to be at moderate risk for a major adverse cardiac event and may benefit from continued work-up and management in the hospital.
The patient is considered high risk for a major adverse cardiac event and thus does not meet ED discharge criteria and will likely benefit from staying in the hospital.  
Based on my clinical assessment and the HEART Score, the patient is considered low risk for a major adverse cardiac event and thus with negative troponin is a reasonable candidate for discharge with outpatient follow-up and return precautions.  
Node Recommendation

Regardless of the overall HEART Score, many physicians will consider patients with a positive troponin to not be in a low risk category.  In patients with chest pain and a concern of ACS who have a positive troponin, further work up and management in the hospital is typically indicated. 

About
Prediction tool to help assess the risk of major adverse cardiac event (MACE) within the next 6 weeks.