How this calculator works
This uses the validated HEART convention with troponin bands at normal, above normal through three times the limit, and above three times. Each of history, ECG, age, risk factors and troponin contributes 0, 1 or 2. Risk factors include diabetes, smoking, hypertension, hypercholesterolaemia, obesity and family history; established atherosclerotic disease gives 2. The original 2008 pilot used a different troponin split. History and ECG assessment require clinical expertise. The score is not the HEART Pathway with serial troponins. The result is an estimate for information only and is not medical advice.
Formula
HEART = History + ECG + Age + Risk factors + Troponin. Total 0 to 10; low 0 to 3, intermediate 4 to 6, high 7 to 10.
Worked example
Age 50 (1), moderately suspicious history (1), normal ECG (0), one risk factor (1) and normal troponin (0) give 3. All five components at 2 give 10.
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Frequently asked questions
Why specify the version?
The initial pilot used different troponin bands. This page uses the later validated three-times-limit convention.
Can normal troponin alone exclude ACS?
No. Timing, assay characteristics, serial testing and the clinical picture matter.
Is a score of 3 a discharge instruction?
No. A clinician must apply an appropriate chest-pain pathway and assess other dangerous causes.