HEART score for chest pain risk stratification

What it is

The HEART score gives the short-term risk of major adverse cardiac events (MACE) in a patient with chest pain. Five components make it up, each worth 0, 1 or 2 points:

1. History: highly suspicious 2 points, moderately suspicious 1 point, slightly or non-suspicious 0 points.
2. Electrocardiogram (ECG) findings: significant ST-depression 2 points, nonspecific repolarization 1 point, normal 0 points.
3. Age: 65 years or over 2 points, over 45 to under 65 years 1 point, 45 years or under 0 points.
4. Risk factors: 3 or more risk factors, or a history of CAD, 2 points; 1 or 2 risk factors 1 point; no risk factors 0 points.
5. Troponin levels: 3 times the normal limit or over 2 points, over 1 to under 3 times the normal limit 1 point, at or under the normal limit 0 points.

The risk factors counted here are DM, a current or recent smoker within one month, HTN, HLP, family history of CAD, and obesity. Troponin and the ECG are part of the total itself, not tests that come after it. The total runs 0 to 10 and puts the patient in one of three bands: 0-3, 4-6 or 7-10 points.