What HEART score is safe for discharge?

A HEART score of 0–3 is classified as low risk, with a 6-week major adverse cardiac event (MACE) rate below 2%. These patients can be safely discharged from the emergency department with outpatient cardiology follow-up, provided their initial and serial troponins are negative.

What does HEART stand for in the HEART score?

HEART is an acronym for the five variables: History (chest pain characteristics), ECG findings, Age, Risk factors for coronary artery disease, and Troponin level. Each component is scored 0–2, giving a maximum total of 10.

HEART-Score-Rechner

Apply to all patients presenting to the emergency department with acute chest pain where ACS must be excluded. Particularly useful for the large proportion of chest pain presentations that are ultimately non-cardiac.

The HEART score is a validated 5-variable risk stratification tool for patients presenting to the emergency department with chest pain of possible cardiac origin. Each of the five components — History, ECG, Age, Risk factors, and Troponin — is scored 0, 1, or 2, giving a maximum of 10 points. Low-risk patients (HEART score 0–3) have a very low 6-week MACE rate (<2%) and can be safely discharged from the emergency department without admission, significantly reducing unnecessary hospitalisation. High-risk patients (score 7–10) require urgent cardiological referral and admission.

ESC 2023 ACS Guidelines endorse validated risk scores (including HEART) as adjuncts to the 0h/1h high-sensitivity troponin pathway for chest pain risk stratification. Low HEART score + negative hs-cTnI at 0h supports safe discharge.

HEART Score for Chest Pain