What is the HEART score?
Pick history, ECG, risk factors, and troponin and enter the age to add up the HEART score for chest pain, its band, and the rate of heart events the original study found. For information only. This is not medical advice or a diagnosis. Do not use it to make treatment decisions without a clinician. No licensed clinician has reviewed this page.
- HEART score
- 1
The HEART score is 1 (Low); in the 2008 study, 2.5% of such patients had a major cardiac event.
Low (0 to 3)
- Low (0 to 3)
- Moderate (4 to 6)
- High (7 to 10)
- Band
- Low
- Event rate in the 2008 study
- 2.5%
- Age points
- 1
HEART score: 1. The HEART score is 1 (Low); in the 2008 study, 2.5% of such patients had a major cardiac event.
HEART score out of 10
This calculator gives general information only. It is not medical advice and does not replace a doctor or other health care provider. Talk with a professional about your results. Terms of use
How to calculate
Adds up the HEART score for chest pain (Six 2008) from history, ECG, age, risk factors, and troponin to a total of 0 to 10, and shows the band and the rate of cardiac events the original study found.
Example with the default inputs (History Slightly suspicious (0), ECG Normal (0), Age 50, Risk factors None known (0), Troponin At or below the normal limit (0)): The HEART score is 1 (Low); in the 2008 study, 2.5% of such patients had a major cardiac event.
Method: HEART = History + ECG + Age + Risk factors + Troponin, each 0 to 2 (total 0 to 10). Low 0 to 3, moderate 4 to 6, high 7 to 10.
- For adults seen in the emergency department with chest pain, as in Six 2008 (120 patients in one hospital).
- Troponin points follow Six 2008 (1 to 2 times, over 2 times the normal limit). Some later tables use 3 times the limit as the upper cutoff.
- The rate is what the 2008 study observed in each band, not a personal prediction.
Worked examples
Each example is checked against the calculator on every build.
- History Slightly suspicious (0), ECG Normal (0), Age 50, Risk factors None known (0), Troponin At or below the normal limit (0) gives HEART score 1, Band Low, Event rate in the 2008 study 2.5%, Age points 1.Source: Six 2008 Table 1: age 45 to 65 scores 1
- History Highly suspicious (2), ECG Nonspecific repolarization changes (1), Age 66, Risk factors 1 or 2 risk factors (1), Troponin At or below the normal limit (0) gives HEART score 6, Band Moderate, Event rate in the 2008 study 20.3%, Age points 2.Source: Six 2008: 2 + 1 + 2 + 1 + 0 = 6, band 4 to 6 had 20.3% events
- History Highly suspicious (2), ECG Significant ST depression (2), Age 70, Risk factors 3 or more, or known atherosclerotic disease (2), Troponin 1 to 2 times the normal limit (1) gives HEART score 9, Band High, Event rate in the 2008 study 72.7%, Age points 2.Source: Six 2008: 2 + 2 + 2 + 2 + 1 = 9, band 7 to 10 had 72.7% events
- History Moderately suspicious (1), ECG Normal (0), Age 44, Risk factors 1 or 2 risk factors (1), Troponin 1 to 2 times the normal limit (1) gives HEART score 3, Band Low, Age points 0.Source: Six 2008: age under 45 scores 0
- History Moderately suspicious (1), ECG Nonspecific repolarization changes (1), Age 65, Risk factors None known (0), Troponin At or below the normal limit (0) gives HEART score 4, Band Moderate, Age points 2.Source: Six 2008 Table 1: 65 or more scores 2
Medical disclaimer
This calculator is for information and education only. It is not medical advice, and its result is not a diagnosis. Do not use it to start, stop, or change a treatment without a clinician who knows your health history. No licensed clinician has reviewed this page. This site's editors checked the formulas and worked examples against published sources. If you think you have a medical emergency, call your local emergency number.
When this does not apply. The score is for adults in an emergency department with chest pain that might come from the heart. It does not apply to a clear heart attack on the ECG (ST elevation), to people who are unstable, or outside a hospital setting.
How the score is worked out
| Part | 0 | 1 | 2 |
|---|---|---|---|
| History | Slightly suspicious | Moderately suspicious | Highly suspicious |
| ECG | Normal | Nonspecific repolarization changes | Significant ST depression |
| Age | Under 45 | 45 to 64 | 65 or more |
| Risk factors | None known | 1 or 2 | 3 or more, or known atherosclerotic disease |
| Troponin | At or below the normal limit | 1 to 2 times the limit | Over 2 times the limit |
HEART score = the sum, 0 to 10 (Six 2008, Table 1). Age is entered in whole years, 18 to 120.
Bands and the event rates of Six 2008: 0 to 3 low (2.5%), 4 to 6 moderate (20.3%), 7 to 10 high (72.7%). The rate is shown with 1 decimal.
Worked examples by hand
Page default. Age 50 scores 1; everything else 0. Total 1, low, 2.5%.
Moderate. History 2, ECG 1, age 66 (2), 1 or 2 risk factors (1), troponin normal (0): 6, moderate, 20.3%.
High. 2 + 2 + age 70 (2) + 2 + troponin 1 to 2 times (1) = 9, high, 72.7%.
Under 45. History 1, ECG 0, age 44 (0), risk 1, troponin 1: 3, low.
Age 65. History 1, ECG 1, age 65 (2), risk 0, troponin 0: 4, moderate.
Other questions people ask
What is the HEART score?
A score for people seen in an emergency department with chest pain, published by Six, Backus, and Kelder in 2008. HEART stands for History, ECG, Age, Risk factors, and Troponin. Each scores 0, 1, or 2, for a total of 0 to 10.
What do the bands mean?
In the 2008 study of 120 patients, major cardiac events (heart attack, a procedure to open the heart arteries, or death) happened in 2.5% of those scoring 0 to 3, 20.3% of those scoring 4 to 6, and 72.7% of those scoring 7 to 10.
Which risk factors count?
Diabetes, smoking, high blood pressure, high cholesterol, a family history of heart disease, and obesity (Six 2008). A history of atherosclerotic disease scores 2 on its own.
How is troponin scored?
In the 2008 paper: at or below the normal limit 0, 1 to 2 times the limit 1, over 2 times 2. Some later tables use 3 times the limit as the upper cutoff. This page follows the 2008 paper, because its event rates belong to its own troponin bands.
How is age scored?
Under 45 scores 0, 45 to 64 scores 1, and 65 or more scores 2. Six 2008 Table 1 prints 45 to 65 for 1 point, but the Methods of the same paper give 2 points at 65 years or older; this page follows the Methods.
Do later studies give the same rates?
No. Larger studies found lower rates in each band (for example Backus 2013 in 2,440 patients), so the 2008 numbers describe that first study, not a personal risk.