HEART Score Calculator

Enter Calculation

History (suspicion of ACS) Slightly suspicious (0) Moderately suspicious (1) Highly suspicious (2)

ECG findings Normal (0) Non-specific repolarization disturbance (1) Significant ST deviation (2)

Age < 45 years (0) 45–64 years (1) ≥ 65 years (2)

Risk factors No known risk factors (0) 1–2 risk factors (1) ≥ 3 risk factors or history of atherosclerotic disease (2)

Initial troponin ≤ normal limit (0) 1–3× normal limit (1) > 3× normal limit (2)

Formula

Results

HEART Score

1

out of 10 — Low risk (0-3): ~1-2% MACE — consider discharge

Approximate 6-week MACE risk	1.7%

What is the HEART Score?

The HEART Score is a clinical decision tool used in emergency departments worldwide to estimate the short-term risk of a major adverse cardiac event (MACE) in patients presenting with chest pain. HEART is an acronym for its five components: History, ECG, Age, Risk factors and Troponin. Each item is scored 0, 1 or 2, producing a total between 0 and 10 that maps to a low, moderate or high risk category.

The HEART score sums five components, each scored 0, 1, or 2.

How to use this calculator

Select the option that best describes your patient for each of the five categories. The calculator adds the points and reports the total score plus the approximate 6-week MACE risk. As a guide: 0–3 is low risk (~1–2% MACE, often suitable for discharge), 4–6 is moderate risk (~12–17%, observation/admission), and 7–10 is high risk (~50–65%, early invasive management). Always combine the score with clinical judgment and local protocols.

The formula explained

The score is a simple sum:

$$\text{Score} = \text{History}\,(0\text{-}2) + \text{ECG}\,(0\text{-}2) + \text{Age}\,(0\text{-}2) + \text{Risk factors}\,(0\text{-}2) + \text{Troponin}\,(0\text{-}2)$$

There is no weighting — each component contributes equally, and the maximum possible value is 10.

Total score maps to low, moderate, and high MACE risk bands.

Worked example

A 58-year-old (Age = 1) with a moderately suspicious history (History = 1), non-specific ECG repolarization changes (ECG = 1), two cardiovascular risk factors (Risk = 1) and a normal troponin (Troponin = 0) scores

$$1 + 1 + 1 + 1 + 0 = 4$$

placing them in the moderate-risk band.

FAQ

Is the HEART Score a diagnosis? No. It estimates risk and supports disposition decisions; it does not diagnose acute coronary syndrome.

What troponin value should I use? Use the initial troponin relative to your assay's normal upper limit.

Can a low score rule out cardiac events? A low score indicates low risk but never zero risk; clinical correlation is essential.