By Zencalcy Editorial TeamLast reviewed About us
The HEART score assesses chest pain using five components: history, ECG, age, risk factors and troponin. Each component scores 0, 1 or 2, producing a total from 0 to 10. This calculator sums the five parts and reports the usual low, moderate or high risk band.
Five-part risk score for undifferentiated chest pain.
| History | |
| ECG | |
| Age | |
| Risk factors | |
| Troponin |
HEART = History(0–2) + ECG(0–2) + Age(0–2) + Risk factors(0–2) + Troponin(0–2)
A total of 0–3 is usually low risk, 4–6 moderate and 7–10 high. The score was designed for undifferentiated chest pain in emergency and urgent-care settings. It supports disposition decisions but does not replace serial troponin testing, ECG review or clinical judgement.
| Symbol | Meaning |
|---|---|
| History | How suspicious the symptom history is, scored 0–2. |
| ECG | How abnormal the ECG is, scored 0–2. |
| Troponin | How elevated the troponin is relative to the local normal limit. |
History scores 2, ECG scores 1, age 70 scores 2, three risk factors score 2 and a troponin between one and three times normal scores 1, for a total of 8 out of 10. That is high risk. A 40-year-old with a non-suspicious history, normal ECG and normal troponin scores 0 out of 10.
Chest pain assessment has to balance missing a dangerous cause against unnecessary admission. The HEART score helps by making the reasoning explicit: symptoms, tracing, age, risk profile and injury marker are each considered and scored. That structure reduces the chance that one striking finding dominates the assessment. It also makes handover between clinicians clearer. The score is weaker when the history is atypical, when the ECG is difficult to interpret or when troponin testing is incomplete. It was not designed for patients with ST-elevation on the ECG, who need an emergency reperfusion pathway. Use the total to support a disposition decision, document the components, and revisit the score if new information arrives during the assessment.
Continue with the Mean Arterial Pressure Calculator, Pulse Pressure Calculator, or the QTc Calculator — or browse more cardiology tools and all health calculators.
History captures how typical the pain is, ECG captures ischaemic changes, age uses three bands, risk factors count atherosclerotic disease or three or more risk factors, and troponin reflects myocardial injury. Each is scored 0, 1 or 2.
Blood pressure, ECG and risk scores are screening aids, not diagnoses. A single reading can be misleading; trends and proper technique matter. Scores estimate population risk and do not replace clinical assessment, anticoagulation decisions or emergency care.
Reference material used to build and check this calculator:
Last reviewed: September 2026. See how we build and check every tool on the about page.
Content updated: September 2026