HEAR Score for Acute Chest Pain
Stratifies risk of MACE in acute chest pain — simplified HEART Score without troponin component.
Score interpretation
HEAR 0–3: Low risk for MACE (~1.7% rate). Suitable for early discharge pathway.
→ Consider early discharge with serial troponin if available. Outpatient follow-up.
HEAR 4–6: Moderate risk (~12% MACE). Observation and serial troponins recommended.
→ Admit for observation, serial ECGs and troponins. Cardiology review.
HEAR 7–8: High risk (~65% MACE). Likely ACS.
→ Urgent cardiology assessment. Consider early invasive strategy.
Interpretation bands for the HEAR. Apply clinical judgement and local guidance.
References
- Backus BE et al. The HEART score for the assessment of patients with chest pain in the emergency department. Crit Pathw Cardiol. 2010;9(3):164-169.
Related
Curated clinical cross-links plus same-class fallbacks.
- HEART Score for Major Adverse Cardiac Events · Chest Pain
- EDACS — Emergency Department Assessment of Chest Pain · Chest Pain
- ACTION ICU Score for Intensive Care in NSTEMI · Chest Pain
- Marburg Heart Score · Chest Pain
- INTERCHEST Clinical Prediction Rule · Chest Pain
- Subtle Anterior STEMI Calculator (4-Variable) · Chest Pain
- Methoxyflurane · Inhaled Analgesic — Acute Pain
- Morphine (Orthopaedic Acute Pain) · Opioid Analgesic — Strong
- Dexketoprofen (Acute Musculoskeletal Pain) · NSAID — Non-selective COX Inhibitor (S-enantiomer of Ketoprofen)
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Dobutamine (Acute HF / Stress Echo) · Inotrope / Acute Heart Failure
- Milrinone · Inodilator / Acute Heart Failure
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.