The HEART Score

The HEART score is a scoring system for patients presenting with chest pain at the emergency department. By assigning zero, one, or two points — towards a patient history, ECG abnormalities, the patient's age, any risk factors present, and troponin measurement — patients receive a score on a scale of 0‒10. The HEART score has been validated in several studies and has proven to be a powerful, easy, and above all practical instrument to separate patients into a low, medium and high risk groups. Patients scoring 0-3 have a 1.6% chance of experiencing a cardiac event, those with a score 4-6 have a 13% chance, and those scoring 7 or higher have a 50% chance of developing a myocardial infarction, PTCA, CABG or death within 6 weeks following presentation. With the HEART score it is immediately clear which patient is eligible for discharge without additional tests or emergency invasive procedures.

In addition to the validation studies, an implementation study with a non-inferiority design has been performed in the Netherlands, which showed that the HEART score is just as safe as usual care. The results of this study are recently published in the Annals of Internal Medicine.

Furthermore, a number of international studies using the HEART score are in progress or have been completed. See Publications for all publications on the HEART score.