HEART_score_for_MACE v.1
Provides a 6-week prediction of the risk of having an adverse major cardiac event.
The HEART Score for Major Cardiac Events (MACE), helps to risk-stratify patients admitted to the emergency department who exhibits chest pain which is deemed appropriate for further investigation for ACS (acute coronary syndrome).
Use in patients ≥21 years old presenting with symptoms indicating the potential of ACS. The score is based on age, history, risk factors, 1-time troponin at admission and EKG. The history question scores either 0, 1 or 2 and is described as follows: \"In the absence of specific elements in terms of pattern of the chest pain, onset and duration, relation with exercise, stress or cold, localisation, concomitant symptoms and the reaction to sublingual nitrates, the history was classified as ‘nonspecific’ and granted zero points. If the patient history contained both nonspecific and suspicious elements, the history was classified as ‘moderately suspicious’ and granted one point. If the history contained primarily specific elements, the history was classified highly suspicious and granted two points.\" (1) Low risk patients score 0-3 with less than 2% risk of MACE (All-cause mortality myocardial infarction, or coronary revascularization) at 6 weeks. High risk patients score > 3 with > 2% risk that rises exponentially. See below: Risk of adverse cardiac event: 0-3: 0.9-1.7% - These patients could be discharged. 4-6: 12-16.6% - These patients need to be admitted to the hospital. ≥7: 50-65% - These patients are candidates for early invasive measures.
Do not use if: < 21 years of age New ST-segment elevation ≥1 mm or other new EKG changes Hypotension Life expectancy less than 1 year, or non-cardiac medical/surgical/psychiatric illness requiring admission.
Ref. 1: Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008 Jun;16(6):191-6. PubMed PMID: 18665203; PubMed Central PMCID: PMC2442661.
OBSERVATION.heart_score_for_mace.v1, OBSERVATION.basic_demographic.v1, EVALUATION.heart_score_for_mace_assessment.v1
