HEART Score (Chest Pain)

Health

Calculate the HEART score to stratify risk of major adverse cardiac events (MACE) in chest pain.

Formula

H+E+A+R+T, each 0–2 pts; max = 10
  • 0–3: Low risk (~1.7% MACE). Consider discharge with follow-up.
  • 4–6: Moderate risk. Observation, serial troponins, further workup.
  • 7–10: High risk. Early invasive strategy.

Moderate risk presentation

Inputs
  • History: 1
  • ECG: 1
  • Age: 1
  • Risk Factors (HTN, hypercholesterolaemia, DM, obesity, smoking, Fx Hx, atherosclerotic Dz): 1
  • Troponin: 1

1+1+1+1+1 = 5. Moderate risk — further evaluation needed.

Frequently asked questions

What does HEART stand for?
H=History, E=ECG, A=Age, R=Risk factors, T=Troponin. Originally published by Six et al. (2008) and validated in multiple ED populations.