The Heart Score

  • The risk of ACS in patients with negative biomarkers and normal ECGs approaches 0.2%.
  • Prior risk scores, such as TIMI and GRACE, provide little, if any benefit, in risk stratification for ED chest pain patients.
  • The HEART score and pathway can risk stratify patients into three separate categories: low (0-3), moderate (4-6), and high score (> 7).
  • Low-risk patients on the HEART pathway demonstrate likelihood of ACS that approaches < 1%, and it is easy to use in the ED.
  • Risk factors, history, ECG, troponin, follow up, gestalt, patients with points 3 or 4, and research design are areas of potential weakness.
  • Further improvement of the HEART pathway at this time is difficult, but in patients at moderate risk, CCTA may hold promise for evaluation of risk. This requires further study.

 

EMK Foundation

The Emergency Medicine Kenya (EMK) Foundation is a not-for-profit organization registered in Kenya in 2015 that aims to ensure timely, accessible and quality lifesaving emergency care in Kenya.