HEART Score

Chest pain — major adverse cardiac event risk

History

Slightly suspicious

Moderately suspicious

Highly suspicious

ECG

Normal

Non-specific repolarisation change

Significant ST deviation

Age

Under 45

45–64

65 or older

Risk factors

No known risk factors

1–2 risk factors

3 or more, or known atherosclerotic disease

Troponin

At or below normal limit

1–3× normal limit

Above 3× normal limit

Evidence

Original publication

Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score.

Netherlands Heart Journal, 2008

Open source

Validation

Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Multicentre cohort: 6-week MACE ~1.7% (score 0–3), ~16.6% (4–6), ~50.1% (7–10).

International Journal of Cardiology, 2013

Open source

Last reviewed: 2026-09

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MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.