HEART Score Calculator (Chest Pain / MACE Risk)
The HEART score risk-stratifies emergency-department patients with chest pain for major adverse cardiac events (MACE) over the next six weeks. It scores five elements — History, ECG, Age, Risk factors and Troponin — each 0, 1 or 2 points, for a total of 0 to 10.
Quick answer
The HEART score adds points (0, 1 or 2 each) for History, ECG, Age, Risk factors and Troponin, giving 0–10. A score of 0–3 is low risk (about 1.7% major adverse cardiac events at six weeks in validation), 4–6 is moderate (about 16.6%), and 7–10 is high (about 50.1%).
HEART components
Low risk (0–3) · ≈1.7% 6-week MACE (Backus 2013)
The HEART score is 0/10: low risk (0–3) (≈1.7% 6-week MACE (Backus 2013)). The score adds History, ECG, Age, Risk factors and Troponin, each 0–2.
HEART estimates 6-week major-adverse-cardiac-event risk to support, not replace, clinical judgement, serial troponin and ECG. Disposition decisions belong to the treating clinician.
How to use the HEART calculator
- 1Score History and ECG. Choose how suspicious the history is (slightly / moderately / highly) and the ECG (normal / non-specific repolarisation changes / significant ST deviation).
- 2Score Age, Risk factors and Troponin. Select the age band (under 45 / 45–64 / 65 or over), the number of risk factors (none / 1–2 / 3 or more or known atherosclerotic disease), and the troponin level relative to the normal limit (normal / 1–3× / over 3×).
- 3Read the HEART score and band. The tool totals the five elements (0–10) and shows the risk band with its validation MACE rate, to discuss with a clinician.
Medical disclaimer: This is general health information, not medical advice. It does not diagnose or treat any condition, and the results are estimates based on public reference formulas. Always consult a qualified doctor about your individual health. If you think you may have a medical emergency, contact your local emergency services immediately.
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Book a consultationFrequently asked questions
What HEART score is low risk?⌄
A HEART score of 0–3 is low risk, associated with roughly 1.7% major adverse cardiac events over six weeks in the Backus 2013 validation. Many chest-pain pathways use this band, often with a normal serial troponin, to support earlier discharge — a decision for the treating clinician.
What does a high HEART score mean?⌄
A HEART score of 7–10 is high risk, around 50% major adverse cardiac events at six weeks in validation, and usually prompts admission and more intensive cardiac evaluation.
Is HEART better than TIMI or GRACE for chest pain?⌄
In emergency chest-pain populations the HEART score has compared favourably with TIMI and GRACE for identifying low-risk patients, but all are decision aids used alongside clinical judgement, ECG and troponin — not replacements for them.
Is my data stored?⌄
No. The calculator runs entirely in your browser; nothing you enter is sent to a server.
Sources & validation
This calculator reproduces the published HEART score, validated for 6-week MACE risk in undifferentiated chest-pain patients in the emergency department.
- Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score (Neth Heart J 2008;16:191-196) — the HEART derivation paper — verified 2026-06-18
- Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department (Int J Cardiol 2013;168:2153-2158) — MACE rates 1.7% / 16.6% / 50.1% for low / moderate / high — verified 2026-06-18
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