{
  "id": "heart-score",
  "version": "1f96ea30915a",
  "status": "published",
  "name": "Heart Score Calculator",
  "question": "What is the HEART score?",
  "summary": "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.",
  "category": "health",
  "subcategory": "clinical",
  "url": "https://www.acalculator.org/health/heart-score-calculator",
  "markdown": "https://www.acalculator.org/health/heart-score-calculator.md",
  "kind": "function",
  "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.",
  "assumptions": [
    "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."
  ],
  "inputs": {
    "$schema": "https://json-schema.org/draft/2020-12/schema",
    "type": "object",
    "properties": {
      "h": {
        "title": "History",
        "description": "How suspicious the story of the chest pain is for a heart cause.",
        "type": "string",
        "enum": [
          "0",
          "1",
          "2"
        ]
      },
      "ecg": {
        "title": "ECG",
        "description": "The electrocardiogram.",
        "type": "string",
        "enum": [
          "0",
          "1",
          "2"
        ]
      },
      "age": {
        "title": "Age",
        "description": "Age in whole years, 18 to 120: under 45 scores 0, 45 to 64 scores 1, 65 or more scores 2.",
        "type": "integer",
        "minimum": 18,
        "maximum": 120
      },
      "r": {
        "title": "Risk factors",
        "description": "Diabetes, smoking, high blood pressure, high cholesterol, family history of heart disease, obesity.",
        "type": "string",
        "enum": [
          "0",
          "1",
          "2"
        ]
      },
      "t": {
        "title": "Troponin",
        "description": "The first troponin compared with the normal limit of the lab.",
        "type": "string",
        "enum": [
          "0",
          "1",
          "2"
        ]
      }
    }
  },
  "outputs": {
    "score": {
      "label": "HEART score",
      "description": "The total of the five parts, 0 to 10.",
      "format": "integer"
    },
    "band": {
      "label": "Band",
      "description": "Low (0 to 3), moderate (4 to 6), or high (7 to 10).",
      "format": "text"
    },
    "rate": {
      "label": "Event rate in the 2008 study",
      "description": "Share of patients in this band who had a heart attack, a procedure to open the heart arteries, or died, in Six 2008.",
      "format": "percent"
    },
    "agePoints": {
      "label": "Age points",
      "description": "0 (under 45), 1 (45 to 64), or 2 (65 or more).",
      "format": "integer"
    }
  },
  "defaultAnswer": {
    "inputs": {
      "h": "0",
      "ecg": "0",
      "age": 50,
      "r": "0",
      "t": "0"
    },
    "outputs": {
      "score": 1,
      "band": "Low",
      "rate": 2.5,
      "agePoints": 1
    },
    "text": "The HEART score is 1 (Low); in the 2008 study, 2.5% of such patients had a major cardiac event."
  },
  "examples": [
    {
      "given": {
        "h": "0",
        "ecg": "0",
        "age": 50,
        "r": "0",
        "t": "0"
      },
      "expect": {
        "score": 1,
        "band": "Low",
        "rate": 2.5,
        "agePoints": 1
      },
      "source": "Six 2008 Table 1: age 45 to 65 scores 1; band 0 to 3 had 2.5% events (hand calculation in content.mdx)"
    },
    {
      "given": {
        "h": "2",
        "ecg": "1",
        "age": 66,
        "r": "1",
        "t": "0"
      },
      "expect": {
        "score": 6,
        "band": "Moderate",
        "rate": 20.3,
        "agePoints": 2
      },
      "source": "Six 2008: 2 + 1 + 2 + 1 + 0 = 6, band 4 to 6 had 20.3% events (hand calculation in content.mdx)"
    },
    {
      "given": {
        "h": "2",
        "ecg": "2",
        "age": 70,
        "r": "2",
        "t": "1"
      },
      "expect": {
        "score": 9,
        "band": "High",
        "rate": 72.7,
        "agePoints": 2
      },
      "source": "Six 2008: 2 + 2 + 2 + 2 + 1 = 9, band 7 to 10 had 72.7% events (hand calculation in content.mdx)"
    },
    {
      "given": {
        "h": "1",
        "ecg": "0",
        "age": 44,
        "r": "1",
        "t": "1"
      },
      "expect": {
        "score": 3,
        "band": "Low",
        "agePoints": 0
      },
      "source": "Six 2008: age under 45 scores 0; 1 + 0 + 0 + 1 + 1 = 3 (hand calculation)"
    },
    {
      "given": {
        "h": "1",
        "ecg": "1",
        "age": 65,
        "r": "0",
        "t": "0"
      },
      "expect": {
        "score": 4,
        "band": "Moderate",
        "agePoints": 2
      },
      "source": "Six 2008 Table 1: 65 or more scores 2; 1 + 1 + 2 = 4 (hand calculation in content.mdx)"
    }
  ],
  "sources": [
    "Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008;16(6):191-196. https://doi.org/10.1007/BF03086144 (open at https://pmc.ncbi.nlm.nih.gov/articles/PMC2442661/, retrieved 2026-10-05)",
    "Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013;168(3):2153-2158. https://doi.org/10.1016/j.ijcard.2013.01.255 (retrieved 2026-10-05)"
  ],
  "related": [],
  "changelog": [
    {
      "date": "2026-10-05",
      "note": "Published after this site's editorial review against the cited sources (no clinician review); the page notices say so."
    }
  ]
}