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The HEART Score
Acute coronary syndrome defines a spectrum of diseases (unstable angina, NSTEMI, STEMI), without clear ECG abnormalities the diagnosis and disposition can be challenging
Several scoring systems have attempted to risk stratify patients: TIMI, PURSUIT, and GRACE
The TIMI & PURSUIT scores were designed to identify higher-risk patients and long-term mortality
A pilot/observational study has utilized a novel scoring system to risk stratify low to intermediate risk patients
The HEART (History, ECG, Age, Risk factors and Troponin) score:
- 0-3 points ~ 2.5% risk (data supporting discharge)
- 4-6 points ~20.3% risk (data supporting observation)
- ≥7points ~ 72.7% risk (data supporting early invasive strategies)
This scoring system is limited given the small study size and requires further study/validation, but may be an easy, quick, and reliable predictor of outcome in chest pain patients
References
Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. Jun 2008; 16(6): 191–196.