Related Experiment Video
Updated: Dec 10, 2025
Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients
Published on: July 12, 2024
Are Patients Discharged on the HEART Pathway Following Up?
Jordyn L Janes1, Matthew J Streitz1, Jessica M Hyams1
1Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234.
Insights
Most patients with chest pain evaluated using the HEART pathway followed up with a doctor. However, only 18% of these patients chose the dedicated HEART Clinic for their follow-up care.
Area of Science:
- Cardiology
- Emergency Medicine
- Health Services Research
Background:
- The HEART pathway aids emergency departments in identifying low-risk chest pain patients for outpatient evaluation.
- The optimal follow-up setting (dedicated HEART Clinic vs. primary care) for these patients requires further investigation.
Purpose of the Study:
- To determine the follow-up rate of patients discharged on the HEART pathway.
- To ascertain the proportion of these patients who utilized the specialized HEART Clinic for follow-up.
Main Methods:
- Secondary analysis of a dataset from a HEART Pathway validation study.
- Included 185 patients with a HEART score of 3 or less, excluding those admitted or with follow-up beyond 6 weeks.
Main Results:
- 67.6% of eligible patients attended follow-up appointments, averaging 7.94 days post-discharge.
- Of those with follow-up, 18% specifically attended the HEART Clinic, while others went to Family Medicine (35.8%) or Internal Medicine (29%).
- No adverse cardiac events (myocardial infarction, death, or need for reperfusion) were reported in the study cohort.
Conclusions:
- A majority of patients discharged via the HEART pathway attend follow-up appointments.
- A small proportion of these patients utilize the dedicated HEART Clinic, suggesting a need to understand patient preferences and clinic accessibility.
Introduction:
The HEART (history, electrocardiogram [ECG], age, risk factors, troponin) pathway is a useful tool in the emergency department to identify patients that are safe for outpatient evaluation of chest pain. A dedicated HEART Clinic to follow-up versus primary care remains a topic that requires further delineation. We sought to identify how many patients discharged on the HEART pathway specifically followed up with the established HEART Clinic.
Materials And Methods:
This is a secondary analysis of a previously published dataset. In an initial validation study of the HEART Pathway, 625 consecutive subjects were identified via chart review, 449 of which were included. We identified subjects for inclusion in this study if they were found to have a HEART score of 3 or less. Subjects were excluded if they were admitted or if their follow-up was beyond 6 weeks.
Results:
Of the 449 subjects, 185 met criteria for study inclusion. 125 (67.6%) had follow-up with an average time of 7.94 days (95% CI: 6.54-9.34). Of those, half had additional testing such as ECG, cardiac computed tomography angiography, and treadmill stress testing. The most common clinics for follow-up were the Family Medicine, Internal Medicine, and HEART Clinic representing 35.8, 29, and 18% of the follow-ups, respectively. No subject died, had a myocardial infarction, or required reperfusion.
Conclusions:
Of the subjects discharged on the HEART Pathway, 67.6% followed up. Of those subjects that followed up, 18% did so at the HEART Clinic.
Related Concept Videos
01:31Discharge Summary Forms
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:29Cardiomyopathy V: Interprofessional Care
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
01:27Coronary Artery Disease V: Interprofessional Care
01:18Endocarditis III: Medical Management