PUBLIC LIBRARY / CALCULATOR

HEART score

Estimates 6-week major adverse cardiac event (MACE) risk in emergency-department patients with chest pain.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

HEART/Backus 2013: 5 components scored 0–2, total 0–10; age ≤45, >45 and <65, ≥65 years; troponin ≤ULN, >1×ULN and <3×ULN, ≥3×ULN; not the serial HEART Pathway

The original HEART was studied in emergency patients with chest pain and suspected non-ST-elevation coronary syndrome. A low score does not mean zero risk, and the original sum is not equivalent to the HEART Pathway with serial assessment. Discharge safety, troponin timing and exclusions require the corresponding protocol.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

History
ECG
Age
Risk factors
Troponin

3/3 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Add 0 to 2 points per item: History, ECG, Age, Risk factors and Troponin. Total 0 to 10.

Risk factors: hypertension, dyslipidemia, diabetes, obesity (BMI > 30), current or recent smoking, family history of premature CAD.

References

Identifier: heart-score

Original clinical content: Brazilian Portuguese.

Method version

HEART/Backus 2013: 5 components scored 0–2, total 0–10; age ≤45, >45 and <65, ≥65 years; troponin ≤ULN, >1×ULN and <3×ULN, ≥3×ULN; not the serial HEART Pathway

heart-score@native-2026-10-04+0302007791db

Backus BE et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol, 2013.

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (3)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

History: Highly suspicious
ECG: Significant ST depression
Age: ≥ 65 years
Risk factors: ≥ 3 or known atherosclerotic disease
Troponin: ≥ 3× the upper limit of normal

{
  "h": "2",
  "e": "2",
  "a": "2",
  "r": "2",
  "t": "2"
}

Expected result

{
  "score": 10
}

Actual result

{
  "score": 10
}

Case 2

reference-002

Inputs

History: Moderately suspicious
ECG: Nonspecific repolarization abnormality
Age: > 45 and < 65 years
Risk factors: None
Troponin: ≤ normal limit

{
  "h": "1",
  "e": "1",
  "a": "1",
  "r": "0",
  "t": "0"
}

Expected result

{
  "score": 3
}

Actual result

{
  "score": 3
}

Case 3

reference-003

Inputs

History: Highly suspicious
ECG: Nonspecific repolarization abnormality
Age: > 45 and < 65 years
Risk factors: 1 or 2
Troponin: ≤ normal limit

{
  "h": "2",
  "e": "1",
  "a": "1",
  "r": "1",
  "t": "0"
}

Expected result

{
  "score": 5
}

Actual result

{
  "score": 5
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.