Podcast: EM:RAP Special Edition- A Defensible Chest Pain ADP

The HEART score was dicussed on a recent EM:RAP special edition. Listen here.

HEART in the News

HEART Impact Study

Following the development of the HEART score, an impact study "More cost-effective management of chest pain patients presenting in the emergency room: application of a validated rule" now aims to document the changes in the emergency rooms where the HEART score is applied.

Read more about this study (Dutch)

The HEART Score (Nederlands)

The HEART score is a newly developed scoring system for patients presenting with chest pain at the emergency room. By assigning zero, one, or two points — towards an atypical patient history, ECG abnormalities, the patient's age, any risk factors present, and elevated Troponine — patients receive a score on a scale of 0‒10. The HEART score has been validated in a retrospective study carried out at four hospitals in the Netherlands, as presented at the ESC 2009 in Barcelona. A prospective validation is nearing completion, of which the preliminary results have been presented at ESC 2010 and ACC 2010.

The HEART score has proven to be a powerful, easy, and above all practical instrument to separate patients into a low, medium and high risk groups. Patients scoring 0-3 have a 1.6% chance of experiencing a cardiac event, those with a score 4-6 have a 13% chance, and those scoring 7 or higher have a 50% chance of developing an infarction, PTCA, CABG or death within 6 weeks following presentation. With the HEART score it is immediately clear which patient is eligible for discharge with or without additional tests or emergency invasive procedures.

In addition to the validation studies an implementation study is in progress in the Netherlands, which is to investigate the effect of applying the HEART score to patients presenting with chest pain to the emergency room. The results of this study are expected in early 2015.

A number of international studies using the HEART score are in progress or have completed, as well.

Given time the HEART score may lead to more efficient, safer and cost-effective treatment of chest pain patients in the emergency room.

Video Presentation

At ESC Barcelona 2009, Barbra Backus presented the results of the retrospective HEART score study. HEART is a scoring model which encourages more efficient, safer, and more cost effective treatment of patients with chest pains.

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