HEART Score: Difference between revisions

Revision as of 03:30, 26 April 2017

The score has been derived and validated in an ED population and predicts 6 week adverse cardiac events^[1]^[2]

Low risk patients have a score 0-3 and have a less than 2% risk of MACE at 6 weeks.

History
Criteria	Point Value
Highly Suspicious	+2
Moderately Suspicious	+1
Slightly Suspicious	0
ECG
Significant ST-depression	+2
Non specific repolarisation disturbance	+1
Normal	0
Age
≥ 65	+2
45-65	+1
≤ 45	0
Risk Factors (Hypercholesterolemia, Hypertension, Diabetes Mellitus, Smoking,Obesity)
≥ 3 risk factors or history of atherosclerotic disease	+2
1-2 risk factors	+1
No risk factors known	0
Troponin
≥ 3× normal limit	+2
1-3× normal limit	+1
≤ normal limit	0

0-3: 2.5% risk of adverse cardiac event. Patient's can be discharged with follow-up.
4-6: 20.3% risk of adverse cardiac event. Patients should be admitted to the hospital for trending of troponin and provocative testing.
≥7: 72.7% risk of adverse cardiac event, suggesting early invasive measures with these patients and close coordination with inpatient cardiology

↑ Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008 Jun;16(6):191-6.PMID 18665203
↑ Backus BE, Six AJ, Kelder JC, Bosschaert MA. et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013 Oct 3;168(3):2153-8 PMID 2346525

Authors:

[1] Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008 Jun;16(6):191-6.PMID 18665203

[2] Backus BE, Six AJ, Kelder JC, Bosschaert MA. et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013 Oct 3;168(3):2153-8 PMID 2346525

[1]

[2]

@@ Line 1: / Line 1: @@
-#REDIRECT[[ACS - Risk Stratification]]
+*The score has been derived and validated in an ED population and predicts 6 week adverse cardiac events<ref>Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008 Jun;16(6):191-6.PMID 18665203</ref><ref>Backus BE, Six AJ, Kelder JC, Bosschaert MA. et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013 Oct 3;168(3):2153-8 PMID 2346525</ref>
+*'''Low risk patients have a score 0-3 and have a less than 2% risk of MACE at 6 weeks.'''
+{| class="wikitable"
+| align="center" style="background:#f0f0f0;"|'''Criteria'''
+| align="center" style="background:#f0f0f0;"|'''Point Value'''
+|-
+! colspan="2" style="background: #ffdead;"| History
+|-
+| Highly Suspicious||+2
+|-
+| Moderately Suspicious||+1
+|-
+| Slightly Suspicious||0
+|-
+! colspan="2" style="background: #ffdead;"| ECG
+|-
+| Significant ST-depression||+2
+|-
+| Non specific repolarisation disturbance||+1
+|-
+| Normal||0
+|-
+! colspan="2" style="background: #ffdead;"| Age
+|-
+| ≥ 65||+2
+|-
+| 45-65||+1
+|-
+| ≤ 45||0
+|-
+! colspan="2" style="background: #ffdead;"| Risk Factors (Hypercholesterolemia, Hypertension, Diabetes Mellitus, Smoking,Obesity)
+|-
+| ≥ 3 risk factors or history of atherosclerotic disease||+2
+|-
+| 1-2 risk factors||+1
+|-
+| No risk factors known||0
+|-
+! colspan="2" style="background: #ffdead;"| Troponin
+|-
+| ≥ 3× normal limit||+2
+|-
+| 1-3× normal limit||+1
+|-
+| ≤ normal limit||0
+|}
+*'''0-3''': 2.5% risk of adverse cardiac event. Patient's can be discharged with follow-up.
+*'''4-6''': 20.3% risk of adverse cardiac event. Patients should be admitted to the hospital for trending of [[troponin]] and provocative testing.
+*'''≥7''': 72.7% risk of adverse cardiac event, suggesting early invasive measures with these patients and close coordination with inpatient cardiology
+[[Category:Cardiology]]