![]() Scores ≥ 7: 50% to 65% risk of adverse cardiac event.In the HEART score study, these patients were admitted to the hospital (11.6% in the retrospective study, 16.6% in the prospective study). Scores 4 to 6: 12% to 16.6% risk of adverse cardiac event.In the HEART score study, these patients were discharged (0.99% in the retrospective study, 1.7% in the prospective study). Scores 0 to 3: 0.9% to 1.7% risk of adverse cardiac event.The HEART score can be applied to any patient presenting to the ED with chest pain who the physician deems appropriate to evaluate for possible ACS. This helps guide management, leading to better resource utilization, shorter hospital and ED stays for low-risk patients, and earlier interventions for moderate- and high-risk patients. The HEART score objectively risk-stratifies patients into low-, moderate-, and high-risk categories. HEART is most widely validated for regular-sensitivity troponin, although it has been studied recently using high-sensitivity troponin (Ljung 2019). HEART outperforms TIMI, safely identifying more low-risk patients. The HEART score is sometimes compared to the TIMI (Thrombolysis in Myocardial Infarction) and GRACE (Global Registry of Acute Coronary Events) risk scores, which are older ACS scores however, TIMI and GRACE differ from HEART in that they measure risk of death for patients with ACS. The user needs some experience taking a detailed chest pain history and reading ECGs in order to adequately apply these 2 components of the score. MACE is defined as all-cause mortality, myocardial infarction, or coronary revascularization. The HEART score helps identify patients with higher risk of having a major adverse cardiac event (MACE) within the following 6 weeks. It was designed to risk stratify patients with un-differentiated chest pain, not those already diagnosed with acute coronary syndromes (ACS). The HEART score helps emergency department (ED) clinicians risk stratify patients with chest pain into low-, moderate-, and high-risk groups. Each of these is scored with 0, 1, or 2 points. HEART is an acronym of its components: history, electrocardiogram (ECG), age, risk factors, and troponin.
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