Emergency Medicine · Cardiology

HEART Pathway for Chest Pain calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

History

ECG

Age (years; ≥45 (+1), ≥65 (+2))

years

Allowed range: 18–110 years

Risk factors (HTN, hyperlipidemia, DM, obesity, smoking, family history, known atherosclerotic disease)

Initial troponin

3-hour repeat troponin elevated

Result

5 fields remaining

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Professional use only

For qualified clinicians. Independently verify inputs, calculations, source guidance, and applicability before any clinical action. This calculator does not replace clinical judgment.

Source: Mahler SA, Riley RF, Hiestand BC et al. The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge. Circ Cardiovasc Qual Outcomes. DOI: 10.1161/CIRCOUTCOMES.114.001384. PMID: 25737484. Scope: HEART Pathway disposition = standard HEART score (History 0-2 + ECG 0-2 + Age 0-2 + Risk factors 0-2 + initial Troponin 0-2, max 10) combined with a serial (0h/3h) troponin gate: low risk requires HEART score ≤3 AND both troponin measurements negative; HEART score ≥4 OR any positive troponin (initial or 3-hour repeat) is not low risk and warrants further workup/admission. (2015)

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Clinical inputs

History
ECG
Age (years; ≥45 (+1), ≥65 (+2))Accepted range: 18 to 110
Risk factors (HTN, hyperlipidemia, DM, obesity, smoking, family history, known atherosclerotic disease)
Initial troponin
3-hour repeat troponin elevated

Primary source

Mahler SA, Riley RF, Hiestand BC et al. The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge. Circ Cardiovasc Qual Outcomes. DOI: 10.1161/CIRCOUTCOMES.114.001384. PMID: 25737484. Scope: HEART Pathway disposition = standard HEART score (History 0-2 + ECG 0-2 + Age 0-2 + Risk factors 0-2 + initial Troponin 0-2, max 10) combined with a serial (0h/3h) troponin gate: low risk requires HEART score ≤3 AND both troponin measurements negative; HEART score ≥4 OR any positive troponin (initial or 3-hour repeat) is not low risk and warrants further workup/admission. (2015)

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