HEART score for chest pain
Risk stratification of chest pain patients
Age [years]
Risk factors
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Risk factors: currently treated diabetes mellitus, current or recent (< one month) smoker, diagnosed hypertension, diagnosed hypercholesterolaemia, family history of coronary artery disease and obesity.
History of atherosclerotic disease: history of coronary revascularisation, myocardial infarction, stroke or peripheral arterial disease.
History of atherosclerotic disease: history of coronary revascularisation, myocardial infarction, stroke or peripheral arterial disease.
Chest pain characteristics
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Specific chest pain elements: pattern of chest pain, onset and duration, relation with exercise, stress or cold, localisation, concomitant symptoms, reaction to sublingual nitrates.
ECG
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Non-specific repolarization disturbances: repolarisation abnormalities without significant ST-segment depression, bundle branch block, typical abnormalities indicative of left ventricular hypertrophy, abnormalities probably due to the use of digoxin, unchanged previously known repolarisation disturbances.
Initial troponin
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URL: upper reference limit
High-sensitivity troponin was not used in the original study.
High-sensitivity troponin was not used in the original study.
HEART score
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Επιπλέον πληροφορίες
Προειδοποίηση
Αυτό το εργαλείο προορίζεται μόνο για εκπαιδευτικούς σκοπούς, δεν αντιπροσωπεύει και δεν αντικαθιστά επαγγελματικές συμβουλές. Αυτό το εργαλείο δεν πρέπει να χρησιμοποιείται για την παροχή ιατρικών διαγνώσεων ή/και ιατρικών θεραπειών.
General description
Chest pain is one of the most common causes of presentation to the emergency room. The focus of the diagnostic process is to identify both low and high risk patients for acute coronary syndrome. The HEART score was designed to be a quick and reliable predictor of outcome in chest pain patients and which could facilitate accurate diagnostic and therapeutic choices. It consists of 5 aspects: History, ECG, Age, Risk factors and Troponin (HEART). Each aspect can be scored with zero, one or two points, depending on the extent of the abnormality. The sum of points can be used to stratify patients into 3 risk groups (low, medium and high risk of major adverse cardiac event in next 6 weeks) with different management strategies.
Chest pain is one of the most common causes of presentation to the emergency room. The focus of the diagnostic process is to identify both low and high risk patients for acute coronary syndrome. The HEART score was designed to be a quick and reliable predictor of outcome in chest pain patients and which could facilitate accurate diagnostic and therapeutic choices. It consists of 5 aspects: History, ECG, Age, Risk factors and Troponin (HEART). Each aspect can be scored with zero, one or two points, depending on the extent of the abnormality. The sum of points can be used to stratify patients into 3 risk groups (low, medium and high risk of major adverse cardiac event in next 6 weeks) with different management strategies.
Formula
Chest pain characteristics: Slightly or non-suspicious (0 points), moderately suspicious (+1 point), highly suspicious (+2 points)
ECG: Normal (0 points), non-specific repolarization disturbance (+1 point), significant ST elevation (+2 points)
Age [years]: < 45 (0 points), 45–64 (+1 point), ≥ 65 (+2 points)
Risk factors: No known risk factors (0 points), 1–2 risk factors (+1 point), ≥ 3 risk factors or history of atherosclerotic disease (+2 points)
Initial troponin: ≤ URL (0 points), > 1 to < 3 times the URL (+1 point), ≥ 3 times the URL (+2 points)
URL: upper reference limit
Result ranges
Low risk
1.7 % probability of MACE within 6 weeks
0–31.7 % probability of MACE within 6 weeks
Moderate risk
16.6 % probability of MACE within 6 weeks
4–616.6 % probability of MACE within 6 weeks
High risk
50.1 % probability of MACE within 6 weeks
7–1050.1 % probability of MACE within 6 weeks
References
Six A, Backus B, Kelder J. Chest pain in the emergency room: value of the HEART score. Netherlands Heart Journal. 2008;16(6):191-196.
Backus B.E. A prospective validation of the HEART score for chest pain patients at the emergency department. International Journal of Cardiology. 2013;168:2153–2158.
Έκδοση
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Σχετικά με αυτό το εργαλείο
Chest pain is one of the most common causes of presentation to the emergency room. The focus of the diagnostic process is to identify both low and high risk patients for acute coronary syndrome. The HEART score was designed to be a quick and reliable predictor of outcome in chest pain patients and which could facilitate accurate diagnostic and therapeutic choices. It consists of 5 aspects: History, ECG, Age, Risk factors and Troponin (HEART). Each aspect can be scored with zero, one or two points, depending on the extent of the abnormality. The sum of points can be used to stratify patients into 3 risk groups (low, medium and high risk of major adverse cardiac event in next 6 weeks) with different management strategies.
