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An end-user's guide to the HEART score and pathway
Brit Long1, Joshua Oliver1, Matthew Streitz1
1San Antonio Military Medical Center, Department of Emergency Medicine, 3841 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States.
The American Journal of Emergency Medicine
|April 2, 2017
Summary
The HEART score and pathway effectively risk stratify emergency department patients with chest pain. This approach aids in safely discharging many patients while ensuring accurate assessment for acute coronary syndrome (ACS).
Area of Science:
- Emergency Medicine
- Cardiology
Background:
- Chest pain is a frequent reason for emergency department visits.
- The HEART score and pathway offer a validated method for risk stratification and patient discharge.
Purpose of the Study:
- To review the essential elements of the HEART score and pathway.
- To discuss current and future applications and considerations for the HEART score and pathway.
Main Methods:
- Evaluation of the HEART score components: History, ECG, Age, Risk Factors, Troponin.
- Analysis of the HEART pathway's clinical utility in chest pain management.
- Review of literature on HEART score accuracy and impact on patient outcomes.
Main Results:
- The HEART score accurately categorizes patients based on key clinical data.
- The HEART pathway demonstrates high sensitivity for major adverse cardiac events (MACE).
- Physician gestalt, follow-up, and shared decision-making are crucial considerations.
Conclusions:
- The HEART pathway provides reliable risk stratification for chest pain patients.
- Careful consideration of all HEART score components is vital for appropriate use.
- Future iterations may integrate additional patient-specific factors.