HEART Score - Mnemonic for Major Adverse Cardiac Events (MACE)

History:

0 points - Slightly Suspicious

1 points - Moderately Suspicious

2 points - Highly Suspicious

 

EKG:

0 points - Normal EKG

1 points - Non-specific repolarization disturbance

2 points - Significant ST deviation

 

Age:

0 points - Age <45

1 points - Age 45–64

2 points - Age ≥65

 

Risk Factors:

0 points - No known risk factors

1 points - 1-2 risk factors

2 points - ≥3 risk factors or history of atherosclerotic disease

 

Troponin:

0 points - ≤ normal limit

1 points - 1-3x normal limit

2 points - >3x normal limit



Score - 6-Week risk of MACE

Low (0-3) - 0.9 - 1.7%

Moderate (4-6) - 12 - 16.6%

High (7-10) - 50 - 65%



High Risk History Features: Retrosternal, pressure, radiation to jaw/shoulder/arms, duration 5–15 min, exertional, perspiration, diaphoresis, improvement with nitrates, patient recognizes symptoms. 

Low Risk History Features: Well localized, sharp, non-exertional, reproducible with palpation.



Risk Factors: HTN, Hyperlipidemia, Diabetes, Obesity, Smoking, Family History



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