HEART Score

HEART Score: Chest pain risk stratification in Emergency/Internal Medicine. Score ≤ 3 = low risk pathway (safe early discharge). Predicts 30-day MACE.

History

ECG

Age

Risk Factors / Known CAD

Troponin

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Adult patients ≥ 18 years presenting with chest pain to Emergency or Internal Medicine

Stratify risk of 30-day MACE (death, MI, or revascularisation)

Guide decision between early discharge vs admission and invasive workup

Combine with serial troponins (at 0h and 2–3h) for optimal accuracy

HEART Score + Troponin Algorithm

HEART score alone is not sufficient. Always combine with two serial high-sensitivity troponin measurements. A HEART 0–3 + two negative hs-troponins = 30-day MACE risk < 2% → safe early discharge.

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 Score — Chest Pain Risk Stratification.

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 Score — Chest Pain Risk Stratification.

FDA MedWatchJul 2, 2026

Heart Pump Recall: Abiomed Removes Impella CP Sets with SmartAssist

Clinical Context

We think this might be relevant to the clinical guidance for HEART Score — Chest Pain Risk Stratification.

HEART Score

When to Use

When to Use

HEART Score + Troponin Algorithm

How it Works

Five Components (0–2 points each)

Risk Strata

Clinical Pearls

Comparison to TIMI and GRACE

Known ECG/Troponin Limitation

Next Steps

Disposition Algorithm

Complementary Tools

The Evidence

Original Derivation

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

Prospective Validation

A prospective validation of the HEART score for chest pain patients at the emergency department.

Origins & History

HEART Score Development

Recent Journal Updates

HEART Score

When to Use

When to Use

HEART Score + Troponin Algorithm

How it Works

Five Components (0–2 points each)

Risk Strata

Clinical Pearls

Comparison to TIMI and GRACE

Known ECG/Troponin Limitation

Next Steps

Disposition Algorithm

Complementary Tools

The Evidence

Original Derivation

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

Prospective Validation

A prospective validation of the HEART score for chest pain patients at the emergency department.

Origins & History

HEART Score Development

Recent Journal Updates