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HEART Score Calculator

Score chest-pain risk on the 0 to 10 HEART scale from history, ECG, age, risk factors, and troponin, with the 6-week cardiac event risk for each band.

HEART score for chest pain

Under 45 scores 0, 45 to 64 scores 1, 65 and over scores 2.

Count hypertension, high cholesterol, diabetes, smoking (current or within 90 days), a family history of early coronary disease, and obesity (BMI over 30). None scores 0, 1 to 2 scores 1, 3 or more scores 2.

Prior heart attack, PCI (stent), CABG (bypass), stroke or TIA, or peripheral arterial disease. On its own this sets the risk-factor component to the full 2 points.

HEART score

3/ 10

Low risk

Estimated 6-week major adverse cardiac event (MACE) risk: 1.7%

History

1 pt

ECG

0 pts

Age

1 pt

Risk factors

1 pt

Troponin

0 pts

Suggested disposition

Low 6-week MACE risk. Early discharge with outpatient follow-up is reasonable in many protocols, ideally paired with a second (serial) troponin to confirm a low-risk pathway.

Bands: 0 to 3 low (about 1.7% MACE), 4 to 6 moderate (about 16.6%), 7 to 10 high (about 50.1%). Figures from the Backus 2013 validation cohort.

Medical disclaimer

This tool is for education only and is not a substitute for professional medical advice, diagnosis, or treatment. The HEART score is one input into the assessment of chest pain and depends on subjective judgments (history suspicion, ECG reading) that belong at the bedside. Never use a low score alone to rule out a heart attack. Anyone with chest pain should be evaluated by a qualified clinician, and emergencies call for immediate care.

Frequently Asked Questions about the HEART Score Calculator

What is the HEART score?
The HEART score helps estimate the short-term risk of a major adverse cardiac event (MACE) in patients who arrive at the emergency department with chest pain. HEART is an acronym for its five parts: History, ECG, Age, Risk factors, and Troponin. It was developed by Six, Backus, and Kelder in 2008 and validated in a large prospective study in 2013.
How is the HEART score calculated?
Each of the five components is scored 0, 1, or 2, then the five numbers are added for a total from 0 to 10. History scores by level of suspicion, ECG by how abnormal it looks, age by band (under 45, 45 to 64, or 65 and over), risk factors by how many are present, and troponin by how many times it exceeds the assay's normal limit. The total is history plus ECG plus age plus risk factors plus troponin.
What do the HEART score risk bands mean?
A total of 0 to 3 is low risk, with about a 1.7 percent chance of a major adverse cardiac event within 6 weeks in the validation cohort. A total of 4 to 6 is moderate risk, around 16.6 percent. A total of 7 to 10 is high risk, around 50.1 percent. Higher bands generally push toward admission and a more invasive work-up.
Which cardiovascular risk factors count for the score?
The classic risk factors are hypertension, high cholesterol, diabetes, current or recent smoking (within 90 days), a family history of premature coronary disease, and obesity (a BMI over 30). None scores 0, one or two score 1, and three or more score 2. A documented history of atherosclerotic disease (prior heart attack, stent, bypass, stroke or TIA, or peripheral arterial disease) sets this component to the full 2 points on its own.
How should I enter the troponin value?
Enter troponin as a multiple of your assay's upper reference limit, so the cut-offs stay independent of which test was used. A value at or below the normal limit scores 0, a value 1 to 3 times the limit scores 1, and a value over 3 times the limit scores 2. If you have the raw result, divide it by your lab's stated normal limit to get the multiple.
Is this calculator a substitute for medical advice?
No. This calculator is for education only and is not a substitute for professional medical advice, diagnosis, or treatment. The HEART score is one input that supports clinical judgment, and it relies on subjective readings such as history suspicion and ECG interpretation that belong at the bedside. Never use a low score by itself to rule out a heart attack, and seek immediate care for chest pain.

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