HEART Pathway

HEART Pathway: Combines the HEART Score with serial troponin monitoring to identify low-risk chest pain patients suitable for early discharge.

History

ECG Findings

Age

Risk Factors

Troponin (0h)

Troponin (3h)

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Adult patients ≥ 21 years old presenting to the Emergency Department with chest pain or symptoms suspicious for Acute Coronary Syndrome (ACS).

To accelerate the identification of low-risk patients suitable for early discharge without further cardiac testing.

Do Not Use If

Patient has STEMI on ECG (activate Cath Lab), new ST-segment depression of ≥1mm, or hemodynamic instability. These patients are high-risk regardless of score.

Last Comprehensive Review: 2026-07-17

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Adult patients ≥ 21 years old presenting to the Emergency Department with chest pain or symptoms suspicious for Acute Coronary Syndrome (ACS).

To accelerate the identification of low-risk patients suitable for early discharge without further cardiac testing.

Do Not Use If

Patient has STEMI on ECG (activate Cath Lab), new ST-segment depression of ≥1mm, or hemodynamic instability. These patients are high-risk regardless of score.

Last Comprehensive Review: 2026-07-17

Recent Journal Updates

JAMAJul 21, 2026

Correction to Primary Composite Outcome in a Trial of Transfusion Strategy

Clinical Context

We think this might be relevant to the clinical guidance for HEART Pathway (Chest Pain Disposition).

Cancer MedicineJul 20, 2026

Inhibition of the Metalloproteinase ADAMTS5 Suppresses Colorectal Cancer Metastasis via the PEDF/Wnt/β‐Catenin Pathway

Clinical Context

We think this might be relevant to the clinical guidance for HEART Pathway (Chest Pain Disposition).

Cancer MedicineJul 16, 2026

Notch3/4 Knockdown Inhibits Colon Adenocarcinoma Progression by Suppressing Tumor Cell Activity and Orchestrating VEGFA‐Dependent Tumor Immune Microenvironment

Clinical Context

We think this might be relevant to the clinical guidance for HEART Pathway (Chest Pain Disposition).

HEART Pathway

When to Use

When to Use

Do Not Use If

How it Works

Pathway Logic

The 1% Threshold

Clinical Pearls

High-Sensitivity Troponin

Impact of the Pathway

The Evidence

Validation Studies

The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge.

Chest pain in the emergency room: value of the HEART score.

Next Steps

Complementary Calculators

When to Use

When to Use

Do Not Use If

How it Works

Pathway Logic

The 1% Threshold

Clinical Pearls

High-Sensitivity Troponin

Impact of the Pathway

The Evidence

Validation Studies

The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge.

Chest pain in the emergency room: value of the HEART score.

Next Steps

Complementary Calculators

Recent Journal Updates

HEART Pathway

When to Use

When to Use

Do Not Use If

How it Works

Pathway Logic

The 1% Threshold

Clinical Pearls

High-Sensitivity Troponin

Impact of the Pathway

The Evidence

Validation Studies

The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge.

Chest pain in the emergency room: value of the HEART score.

Next Steps

Complementary Calculators

When to Use

When to Use

Do Not Use If

How it Works

Pathway Logic

The 1% Threshold

Clinical Pearls

High-Sensitivity Troponin

Impact of the Pathway

The Evidence

Validation Studies

The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge.

Chest pain in the emergency room: value of the HEART score.

Next Steps

Complementary Calculators

Recent Journal Updates