Recognize heart disease with HEART score
25 April 2017
Rapid assessment of the risk of a heart attack is crucial. The HEART score method, developed by two Dutch physicians, can provide help.
If a patient with chest pain arrives at the emergency department, a quick evaluation of the risk of a heart attack is important. This can prevent damage to the heart or even death. On the other hand, research or acute intervention involves risk of complications. A dilemma for the physician.
By using the HEART score it quickly becomes clear whether the patient can be discharged from the emergency department without further investigation, or if additional tests or acute intervention is required. The score was developed in 2008 by two Dutch physicians. The patient scores zero, one or two points for ECG abnormalities, age, risk factors such as smoking, the complaints he had as he was admitted, and a blood test. The total number of points, between zero and ten, shows whether there is a low, medium or high risk of a heart attack. On the basis of the overall HEART score, a recommendation is provided: should the patient be admitted for further investigation or is the risk of a heart attack so low that the patient can be discharged? Patients with low risk of a heart attack would be reassured and could go home without further diagnostic research or hospitalization. The costs could therefore decrease.
Several previous studies show that the HEART score is a powerful, simple and, above all, practical instrument for distinguishing low risk patients from patients who require further investigation or treatment. A recent Dutch implementation study shows that the HEART score is safe in daily use at emergency departments. This study showed only minor effects on costs. This may be because physicians are still reluctant to actually adjust the recommendation for these low risk patients. The HEART score is being used and researched worldwide. Over time, the effect of this score may therefore increase. More information: www.heartscore.nl. The magazine Annals of Internal Medicine has published the results.