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HEART SCORE History (slightly 0, moderately 1, highly 2) EKG (normal 0, nonspecific 1, significant ST dev 2) Age (<45 0, 45-65 1, >542) Risk Factors (none 0, 1-2 1, >3 2) Initial troponin (<limit 0, 1-3x normal 1, >3x normal 2) Total= <a href='http://www.mdcalc.com/heart-score-for-major-cardiac-events/'>http://www.mdcalc.com/heart-score-for-major-cardiac-events/</a> Upon calculating the patient's HEART score, they were found to have a score of 0-3, which indicates low risk, so the patient can be safely discharged with the understanding that they need to make an appointment with a primary care doctor to be referred for a stress test within the next 48-72 hours, or if they cannot arrange that they are to return to the ED, or sooner than that if they have any changing, persistent, or worsening symptoms. In the studies referenced below, the patients in the low risk group were discharged and found to have a 0.9-1.7% change of having a major adverse cardiac event (defined as revascularization, myocardial infarction, or all-cause mortality) within 6 weeks when studied both retrospectively and prospectively. Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008 Jun;16(6):191-6. PMID: 18665203 Backus BE, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013 Oct 3;168(3):2153-8. PMID: 23465250.



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