HEART Score Calculator for Chest Pain
Five elements, each scored 0 to 2, that sort the ED chest pain patient into discharge, observe, or admit. Pick the honest answer for each and the score does the rest.
The bands and what to do with them
| Score | Risk of major adverse cardiac events | Usual disposition |
|---|---|---|
| 0 to 3 | Low, on the order of 2 percent in the validation cohorts | Discharge with follow-up, if the troponins are negative |
| 4 to 6 | Intermediate, roughly one in six | Observe, serial troponins, usually stress testing or imaging |
| 7 to 10 | High, on the order of half | Admit, cardiology involvement, early invasive strategy discussion |
The score's honesty depends on the History element, which is the only subjective one: a story of exertional pressure radiating to the arm with diaphoresis is a 2 no matter how normal the ECG looks. Score it before you see the troponin, or the troponin will quietly rewrite your story. The full chest pain workup, and what belongs in the note, is covered in common night calls and the cardiology rotation guide; documenting the risk assessment defensibly is covered in charting and legal risk.
Get the printable tracker sheet pack
These are the printable PDF scut sheets we use on the wards: admit sheets and daily progress notes laid out in the exact order you present on rounds, patient trackers with an active problem list and separate columns for home and hospital medications, a ten patient sheet for bigger lists, and a cardiology and telemetry note. Print them double sided, fold them into your pocket, and stop rewriting the same information three times a day.
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This is not medical advice. This calculator is an educational tool for clinicians and trainees. Risk scores support judgment, they do not replace it. Institutional pathways and current references govern.