How is the HEART score calculated?

Each of History, ECG, Age, Risk factors, and Troponin is scored 0, 1, or 2 and summed to a 0–10 total. You supply the ECG interpretation and the troponin level relative to your own assay’s normal limit; the tool does not read either for you.

What do the HEART risk bands mean?

A total of 0–3 is low risk (roughly 1–2% MACE in the original cohort), 4–6 is moderate (about 12–20%), and 7–10 is high (about 50–73%). These are published risk bands, not a diagnosis.

Does the score tell me to discharge or admit?

No. The original paper attached dispositions to the bands, but this tool deliberately does not reproduce them as instructions. Disposition — discharge, observe, or refer for angiography — is the treating clinician’s decision.

Does any of the data I enter leave my browser?

No. The scoring runs entirely in your browser; nothing you enter is sent to a server or stored. The print option produces a clean worksheet you can save as a PDF.

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HEART score calculator

Score the five HEART components — History, ECG, Age, Risk factors, and Troponin — that you assess yourself, for the published major-adverse-cardiac-event (MACE) risk band. A scoring aid, not a disposition — and nothing you enter leaves your device.

For a patient with chest pain, set each of the five components to 0, 1, or 2. You supply the ECG read and the troponin level against your own assay; the tool only tallies.

Risk factors: Hypertension, hypercholesterolaemia, diabetes mellitus, obesity, smoking, and a family history of premature coronary artery disease. Known atherosclerotic disease (prior MI, PCI, CABG, stroke/TIA, or peripheral arterial disease) scores the full 2 points on its own.

HEART total

Set a value in all five rows to see the total and its cited MACE risk band.

Published cohort MACE risk for this band (Six et al. 2008), not this patient's guaranteed risk. Low ~1.7%, moderate ~12–20%, high ~50–73%.

Not a disposition

What clinicians do with this number is a separate, clinical decision. The original paper attached dispositions to the bands (broadly: a low band identifies patients at low MACE risk, while higher bands prompt observation or referral for further cardiac investigation), but that decision weighs the full clinical picture, serial testing, and local pathways, and rests with the treating clinician. This tool does not discharge, admit, or refer any patient.

Screening aid, not a diagnosis — and not a discharge instruction. This tool only tallies the five 0/1/2 values you select against the published HEART score; it does not interpret an ECG, a troponin assay, or symptoms, and you supply every input. It is not a medical device and is not CDSCO- or FDA-cleared. The score and the published MACE percentages support, not replace, clinical assessment — disposition (discharge, admit, or refer for angiography) is the treating clinician's decision and is deliberately not produced by this tool. Any clinically concerning chest pain warrants immediate in-person assessment regardless of a low score.

Privacy: Runs entirely in your browser — nothing you enter is sent to a server or stored.

Components, 0/1/2 anchors, and MACE bands reproduced from: 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 (PMC2442661)..

How the HEART score works

The HEART score grades five things a clinician assesses in chest pain — History, ECG, Age, Risk factors, and Troponin — each 0, 1, or 2, for a 0–10 total that maps to a low, moderate, or high risk of a major adverse cardiac event over the next six weeks. The clinician supplies the ECG read and the troponin level relative to their own assay; the tool only tallies. It reports the risk band, never the discharge-or-admit decision, which stays with the treating clinician.

Many teams still tally the components on a scrap of paper. If you run a cardiology clinic workflow on Avinya Plus, the same arithmetic can live on the note: build the five components into a cardiology or casualty template and total them with the formula engine, so the score sits beside the examination instead of on a calculator. The arithmetic is the engine's; the disposition stays yours.

Frequently asked questions

How is the HEART score calculated?: Each of History, ECG, Age, Risk factors, and Troponin is scored 0, 1, or 2 and summed to a 0–10 total. You supply the ECG interpretation and the troponin level relative to your own assay’s normal limit; the tool does not read either for you.
What do the HEART risk bands mean?: A total of 0–3 is low risk (roughly 1–2% MACE in the original cohort), 4–6 is moderate (about 12–20%), and 7–10 is high (about 50–73%). These are published risk bands, not a diagnosis.
Does the score tell me to discharge or admit?: No. The original paper attached dispositions to the bands, but this tool deliberately does not reproduce them as instructions. Disposition — discharge, observe, or refer for angiography — is the treating clinician’s decision.
Is a low HEART score safe?: A low score lowers but does not eliminate risk, and any clinically concerning chest pain warrants immediate in-person assessment regardless of the score. The score supports, it does not replace, clinical judgement.
Does any of the data I enter leave my browser?: No. The scoring runs entirely in your browser; nothing you enter is sent to a server or stored. The print option produces a clean worksheet you can save as a PDF.

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 (PMC2442661).

The five components, 0/1/2 anchors, and MACE risk bands are reproduced from Six et al., Neth Heart J 2008 (PMC2442661). The clinician supplies the ECG read and the troponin ratio against their own assay limit; the tool interprets neither. Disposition is deliberately not produced. Reviewed against the source on 2026-06-29.

Keep the chest-pain score on the record.

In Avinya Plus you can build the HEART components into a cardiology or casualty template, total them automatically, and keep the risk band on the note — disposition stays with you. See it on a quick demo.