Academic emergency medicine : official journal of the Society for Academic Emergency Medicine | 2019
ED Chest Pain Rules: Follow Your HEART?
Abstract
The HEART Score is yet another clinical prediction tool to identify emergency department (ED) chest pain patients who are at low risk for a short-term major cardiac event (MACE).(1) The acronym is clever; HEART: History (H), electrocardiogram (ECG, E), Age (A), Risk Factors (R), and Troponin (T). Each of the five variables is assigned 2 points for convincing evidence, 1 point for partial evidence, and 0 points for no convincing evidence. Another older clinical prediction tool, the TIMI (thrombolysis in myocardial infarction) risk score(2), also includes history, ECG, age, risk factors, and cardiac biomarker findings, but the scoring system is less finely divided; each variable has 2 values, not 3. For example, HEART assigns 2 points for troponin > 3 times normal limit, 1 point for troponin 1-3 times normal limit, and 0 points for troponin ≤ normal limit. This article is protected by copyright. All rights reserved.