HEART Score: HEART Score for Major Adverse Cardiac Events

6-week MACE risk in ED patients with chest pain. Free to use.

cardiology, emergency 5 items Updated 2026-05-05

Score HEART Score below → Download printable PDF View source paper (DOI)
What is HEART Score? HEART Score (HEART Score for Major Adverse Cardiac Events) is a validated instrument used to assess 6-week mace risk in ed patients with chest pain. It comprises 5 items.

What is HEART Score?

HEART Score (HEART Score for Major Adverse Cardiac Events) is a validated clinical instrument used to assess 6-week mace risk in ed patients with chest pain. The instrument contains 5 items.

Source / attribution: Six AJ et al., Neth Heart J 2008

Clinical context: when HEART Score is used

Like all screening or assessment instruments, HEART Score is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.

Score HEART Score

Answer all 5 items below to see your HEART Score score and interpretation.

Each item is scored on a 3-point scale (0–2). Your score updates live as you answer.

All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.

How HEART Score is scored

HEART Score uses simple summation: each item's selected response is converted to a numeric value, and the values are added to produce a total score. Reverse-scored items are inverted before summation.

Scoring notes: Educational use only. Not a substitute for clinical judgment.

HEART Score score interpretation

The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.

Score rangeBandInterpretation
0–3Low riskLow risk — home with follow-up may be safe.
4–6Moderate riskMedium risk — admit for observation.
7–10High riskHigh risk — urgent cardiac workup.

How to score HEART Score: a step-by-step worked example

This is an illustrative walkthrough, not a real patient. Follow the same four steps with your own answers — or use the live calculator at the top of this page.

Step 1 — Score each item

Read each question and choose the response that best fits. Each response has a number next to it — that number is the item's score. The example below uses illustrative answers.

#ItemExample responseScore
1HistoryModerately suspicious1
2ECGNon-specific repolarization disturbance1
3Age45–641
4Risk factors1–2 risk factors1
5Initial troponin1–3× normal limit1

Step 2 — Add up the scores

Add up all the item scores you noted in Step 1.

1 + 1 + 1 + 1 + 1 = 5

Step 3 — Look up the band

Find the row in the interpretation table whose range contains your total:

Total = 5 falls between 4 and 6Moderate risk

Step 4 — What does this mean clinically?

Moderate risk. 12–17% MACE — admit for observation.

A score is one input alongside history and examination. HEART Score supports clinical judgment — it does not replace it.

Score HEART Score with your own answers above →

Limitations & common pitfalls

How HEART Score compares to other cardiology scales

If HEART Score doesn't fit your context, related instruments in cardiology include:

ScaleMeasuresItemsTime
CHA2DS2-VAScAnnual stroke risk in non-valvular atrial fibrillation8
HAS-BLED1-year risk of major bleeding on oral anticoagulation9
NYHA Functional ClassFunctional capacity in heart failure1
APGAR ScoreRapid assessment of newborn at 1 and 5 min5
ASA Physical StatusPre-operative health status1
CURB-6530-day mortality in community-acquired pneumonia5
Glasgow Coma ScaleLevel of consciousness after head injury3
Katz ADLFunctional independence in basic ADLs6

Frequently asked questions about HEART Score

What does HEART Score measure?

HEART Score (HEART Score for Major Adverse Cardiac Events) is a validated instrument that assesses 6-week mace risk in ed patients with chest pain.

How many items are on HEART Score?

HEART Score contains 5 items. Items are summed to produce a total score.

What is a high HEART Score score?

Scores of 7–10 fall in the "High risk" band. High risk — urgent cardiac workup.

What is a low HEART Score score?

Scores of 0–3 fall in the "Low risk" band. Low risk — home with follow-up may be safe.

Is HEART Score free to use?

Yes — HEART Score is in the public domain and free for clinical, educational, and research use without permission.

What is the source paper for HEART Score?

Six AJ et al. Neth Heart J. 2008;16(6):191-196.

Can HEART Score replace clinical judgment?

No. HEART Score is a structured assessment aid. A score is one input alongside history, examination, and clinical context. Treatment decisions should never rest on a screening score alone.

References & validation

HEART Score is supported by the following peer-reviewed sources: