HEART Score (chest pain)
Score the HEART score for undifferentiated chest pain in the emergency department.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- History
- 1
- EKG
- 0
- Age
- 1
- Risk factors
- 1
- Troponin
- 0
Result: HEART 3 - low-risk band (~1.7% MACE at 6 weeks).
The tool opens with these values already filled in. Replace them with your own.
What the result means
- 0-3
- Low risk (~1.7% MACE at 6 weeks per Backus 2013 validation). Suitable for early discharge per source.
- 4-6
- Moderate risk (~16.6% MACE at 6 weeks). Admission for clinical observation per source.
- 7-10
- High risk (~50% MACE at 6 weeks). Early invasive strategy per source.
What you enter
- History (0 slightly / 1 moderately / 2 highly suspicious)
- EKG (0 normal / 1 nonspecific / 2 significant ST deviation)
- Age (0 < 45 / 1 45-64 / 2 >= 65)
- Risk factors (0 none / 1 one-two / 2 >= 3 or atherosclerosis)
- Troponin (0 normal / 1 1-3x ULN / 2 > 3x ULN)
What this is
Sophie Well sums the five items (History, ECG, Age, Risk factors, Troponin) on their 0-2 scales and returns the total (0-10) plus the conventional risk band - low (0-3), moderate (4-6), high (7-10) - that pairs with serial troponin to guide disposition. Source: Six AJ, Backus BE, Kelder JC. Neth Heart J 2008.
When to use it
Use HEART at the bedside in adult ED chest pain to triage between early discharge with outpatient follow-up, observation with serial troponin, and admission for early invasive workup. HEART is one input into MACE risk; institutional pathways (HEART Pathway, ADAPT) layer on serial high-sensitivity troponin and shared decision-making.
How this is calculated
Six AJ, Backus BE, Kelder JC. HEART score. Neth Heart J. 2008;16(6):191-196. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.
More in Cardiology.