HEART Score Calculator for Assessing the Risk of Major Adverse Cardiac Events
This dot phrase template quickly completes a HEART Score assessment in your EMR, classifying the risk of a MACE occuring in patients.
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Medical News Today says doctors use the HEART score to identify people with an increased risk of having a major adverse cardiac event (MACE) within 6 weeks.
This snippet makes it easy to complete a HEART score assessment, outputting the number of points and the overall risk.
HEART score for major cardiac events
HEART Score
History: {formmenu: default=Slightly suspicious; Moderately suspicious; Highly suspicious; name=history}
EKG: {formmenu: default=Normal; Non-specific repolarization disturbance; Significant ST deviation; name=EKG} 1 point: No ST deviation but LBBB, LVH, repolarization changes (e.g. digoxin); 2 points: ST deviation not due to LBBB, LVH, or digoxin.
Age: {formmenu: default=<45; 45-64; >65; name=age}
Risk Factors: {formmenu: default=No known risk factors; 1-2 risk factors; >3 risk factors or history of atherosclerotic disease; name=riskfactors} HTN, hypercholesterolemia, DM, obesity (BMI >30 kg/m²), smoking (current, or smoking cessation ≤3 mo), positive family history (parent or sibling with CVD before age 65); atherosclerotic disease: prior MI, PCI/CABG, CVA/TIA, or peripheral arterial disease.
Initial troponin: {formmenu: default=<normal limit; 1-3x normal limit; >3x normal limit; name=troponin} Use local, regular sensitivity troponin assays and corresponding cutoffs
{=score} points {if: score<4}Low Score (0-3 points)
Risk of MACE of 0.9-1.7%.{elseif: score<7}Moderate Score (4-6 points)
Risk of MACE of 12-16.6%.
If troponin is positive, many experts recommend further workup and admission even with a low HEART Score.{elseif: score>6}High Score (7-10 points)
Risk of MACE of 50-65%.{endif}
{if: history="Moderately suspicious"; trim=yes}{q1=1}{elseif: history="Highly suspicious"}{q1=2}{else}{q1=0}{endif}{if: EKG="Non-specific repolarization disturbance"}{q2=1}{elseif: EKG="Significant ST deviation"}{q2=2}{else}{q2=0}{endif}{if: age="45-64"}{q3=1}{elseif: age=">65"}{q3=2}{else}{q3=0}{endif}{if: riskfactors="1-2 risk factors"}{q4=1}{elseif: riskfactors=">3 risk factors or history of atherosclerotic disease"}{q4=2}{else}{q4=0}{endif}{if: troponin="1-3x normal limit"}{q5=1}{elseif: troponin=">3x normal limit"}{q5=2}{else}{q5=0}{endif}{score=q1+q2+q3+q4+q5; trim=yes}
EKG: {formmenu: default=Normal; Non-specific repolarization disturbance; Significant ST deviation; name=EKG} 1 point: No ST deviation but LBBB, LVH, repolarization changes (e.g. digoxin); 2 points: ST deviation not due to LBBB, LVH, or digoxin.
Age: {formmenu: default=<45; 45-64; >65; name=age}
Risk Factors: {formmenu: default=No known risk factors; 1-2 risk factors; >3 risk factors or history of atherosclerotic disease; name=riskfactors} HTN, hypercholesterolemia, DM, obesity (BMI >30 kg/m²), smoking (current, or smoking cessation ≤3 mo), positive family history (parent or sibling with CVD before age 65); atherosclerotic disease: prior MI, PCI/CABG, CVA/TIA, or peripheral arterial disease.
Initial troponin: {formmenu: default=<normal limit; 1-3x normal limit; >3x normal limit; name=troponin} Use local, regular sensitivity troponin assays and corresponding cutoffs
{=score} points {if: score<4}Low Score (0-3 points)
Risk of MACE of 0.9-1.7%.{elseif: score<7}Moderate Score (4-6 points)
Risk of MACE of 12-16.6%.
If troponin is positive, many experts recommend further workup and admission even with a low HEART Score.{elseif: score>6}High Score (7-10 points)
Risk of MACE of 50-65%.{endif}
{if: history="Moderately suspicious"; trim=yes}{q1=1}{elseif: history="Highly suspicious"}{q1=2}{else}{q1=0}{endif}{if: EKG="Non-specific repolarization disturbance"}{q2=1}{elseif: EKG="Significant ST deviation"}{q2=2}{else}{q2=0}{endif}{if: age="45-64"}{q3=1}{elseif: age=">65"}{q3=2}{else}{q3=0}{endif}{if: riskfactors="1-2 risk factors"}{q4=1}{elseif: riskfactors=">3 risk factors or history of atherosclerotic disease"}{q4=2}{else}{q4=0}{endif}{if: troponin="1-3x normal limit"}{q5=1}{elseif: troponin=">3x normal limit"}{q5=2}{else}{q5=0}{endif}{score=q1+q2+q3+q4+q5; trim=yes}
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Note: This snippet is based on an original calculator by Dr. Barbra Backus, found here, on mdcalc.com. We recommend validating the outcomes of this snippet against standards to ensure that the result is accurate to those standards.
