HEART Score Calculator
Calculate the HEART score for chest pain in the emergency department, combining History, ECG, Age, Risk factors, and Troponin to stratify short-term major adverse cardiac event risk.
Formula & Reference
| Variable | Symbol | Formula | Units |
|---|---|---|---|
| HEART Score Calculator | — | HEART = History + ECG + Age + Risk factors + Troponin | points |
Step-by-Step Examples
32-year-old, atypical chest pain, normal ECG, no risk factors, troponin negative.
- History slightly suspicious → 0
- ECG normal → 0
- Age < 45 → 0
- No risk factors → 0
- Troponin normal → 0
- Total = 0
58-year-old smoker with hypertension, moderately suspicious history, non-specific ECG changes, troponin normal.
- History moderately suspicious → 1
- ECG non-specific → 1
- Age 45–64 → 1
- 2 risk factors → 1
- Troponin normal → 0
- Total = 4
71-year-old with prior MI and diabetes, highly suspicious history, ST depression, troponin 5× upper limit.
- History highly suspicious → 2
- Significant ST deviation → 2
- Age ≥ 65 → 2
- Known atherosclerotic disease → 2
- Troponin > 3× → 2
- Total = 10
Real-World Applications
Common Mistakes to Avoid
The score was derived and validated in patients presenting with chest pain. Using it elsewhere produces a number without a validated meaning.
A low HEART score supports, but does not by itself justify, discharge. Ongoing pain, dynamic ECG changes, or clinical concern override the number entirely.
The History component is the most subjective and most influential element. Inconsistent scoring here is the main source of variability between clinicians.