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Chest pain in the emergency room: value of the HEART score

A J Six1, B E Backus, J C Kelder

  • 1Zuwe Hofpoort Hospital, Woerden, the Netherlands.

Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
|July 31, 2008
PubMed

Insights

The HEART score accurately predicts outcomes for chest pain patients. A low score suggests discharge, while a high score indicates the need for invasive strategies, improving diagnostic and therapeutic decisions.

Area of Science:

  • Cardiology
  • Emergency Medicine

Background:

  • Chest pain is a frequent emergency room presentation, often leading to diagnostic uncertainty for non-ST-elevation acute coronary syndrome.
  • The HEART score (History, ECG, Age, Risk factors, Troponin) is a validated tool for risk stratification.

Purpose of the Study:

  • To evaluate the predictive value of the HEART score for clinical endpoints in emergency room patients presenting with chest pain.
  • To assess the HEART score's utility in guiding diagnostic and therapeutic decisions.

Main Methods:

  • Analysis of clinical data from 122 emergency room patients with chest pain.
  • Calculation and evaluation of the HEART score for 120/122 patients.
  • Correlation of HEART score with patient endpoints.

Main Results:

  • Twenty-nine patients experienced endpoints, including myocardial infarction (16), revascularization (20), and death (2).
  • Patients with endpoints had a significantly higher HEART score (6.51±1.84) compared to those without (3.71±1.83; p<0.0001).
  • HEART scores of 0-3 (2.5% endpoint risk) suggest immediate discharge; 4-6 (20.3% risk) indicate observation; ≥7 (72.7% risk) support early invasive strategies.

Conclusions:

  • The HEART score is an easy, quick, and reliable predictor of outcomes in chest pain patients.
  • It facilitates accurate diagnostic and therapeutic choices, optimizing patient management.
Abstract

Keywords:
acute coronary syndromechest painemergency room

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