HEART Score Calculator
Calculate the HEART score for chest pain patients to estimate major adverse cardiovascular event risk.
What Is the HEART Score?
The HEART score stratifies chest pain patients without known acute coronary syndrome (ACS) by 6-week major adverse cardiovascular event (MACE) risk. MACE includes all-cause mortality, myocardial infarction, and need for revascularization. Related tools include the Heart Disease Risk Calculator and Duke Treadmill Score Calculator.
Scoring Components
- Age — 0 to 2 points by decade group
- ECG — 0 to 2 points for repolarization or ST changes
- History — 0 to 2 points for ACS-like chest pain features
- Initial troponin — 0 to 2 points by elevation above lab normal
- Risk factors — 0 to 2 points for diabetes, smoking, hypertension, hyperlipidemia, obesity, or family CAD
Risk Categories
- 0 to 3 — Low risk (~1.7% MACE at 6 weeks)
- 4 to 6 — Moderate risk (12% to 17%)
- 7 to 10 — High risk (50% to 65%)
Frequently Asked Questions
Who should receive a HEART score?
It applies to emergency department patients with chest pain who do not already have a confirmed ACS diagnosis.
What MACE risk corresponds to a score of 3?
Scores of 3 or less are low risk with approximately 1.7% six-week MACE in validation cohorts.
How is troponin scored?
Normal troponin scores 0, elevation 1 to 3 times the upper limit scores 1, and more than 3 times the upper limit scores 2. Use your laboratory reference range.
Can low-risk patients go home?
Low HEART scores support early discharge after appropriate clinical review, but individual comorbidities and shared decision-making always apply.
Does HEART replace clinical judgment?
No. HEART is a decision support tool. Atypical presentations, dynamic ECG changes, or clinician concern may override score-based pathways.
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