Acute coronary syndrome

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📊 HEART Score Calculator [show]

HEART Score

HEART Score Calculator

Criteria	Select One
History	Slightly suspicious (0)	Moderately suspicious (+1)	Highly suspicious (+2)
EKG	Normal (0)	Non-specific repolarization disturbance (+1)	Significant ST deviation (+2)
Age	<45 (0)	45–64 (+1)	≥65 (+2)
Risk Factors HTN, hypercholesterolemia, DM, obesity (BMI >30), smoking, family hx CVD, or hx atherosclerotic disease	No known risk factors (0)	1–2 risk factors (+1)	≥3 risk factors or hx atherosclerotic disease (+2)
Initial Troponin	≤normal limit (0)	1–3× normal limit (+1)	>3× normal limit (+2)
HEART Score	/ 10

Interpretation

0–3	Low Risk — 0.9–1.7% risk of MACE. Consider discharge with outpatient follow-up.
4–6	Moderate Risk — 12–16.6% risk of MACE. Consider admission for observation and further workup.
7–10	High Risk — 50–65% risk of MACE. Consider early invasive measures (cardiology consult, catheterization).

References

Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008;16(6):191-196. PMID 18665203. Backus BE, Six AJ, Kelder JC, et al. Prospective validation of the HEART score for chest pain patients. Int J Cardiol. 2013;168(3):2153-2158. PMID 23465250. Mahler SA, Riley RF, Hiestand BC, et al. The HEART Pathway randomized trial. Circ Cardiovasc Qual Outcomes. 2015;8(2):195-203. PMID 25737484.

📊 TIMI UA/NSTEMI Calculator [show]

TIMI UA/NSTEMI Score

TIMI Risk Score for UA/NSTEMI

Risk Factor	No (0)	Yes (+1)
Age ≥65 years	1
≥3 CAD risk factors (HTN, DM, hyperlipidemia, family hx, smoking)	1
Known CAD (stenosis ≥50%)	1
ASA use in past 7 days	1
Severe angina (≥2 episodes in 24h)	1
ST deviation ≥0.5mm	1
Positive cardiac marker (troponin)	1
TIMI Score	/ 7

Interpretation
0-2	Low risk — 4.7-8.3% risk of all-cause mortality, new/recurrent MI, or severe ischemia at 14 days.
3-4	Moderate risk — 13.2-19.9% risk. Consider early invasive strategy.
5-7	High risk — 26.2-40.9% risk. Early invasive strategy recommended.

References
Antman EM, Cohen M, Bernink PJ, et al. The TIMI risk score for unstable angina/non-ST elevation MI. JAMA. 2000;284(7):835-842. PMID 10938172.