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Introduction:
Chest pain is the most common potentially life-threatening presentation to the emergency department (ED). Furthermore, the identification of acute coronary syndrome (ACS) including its risk stratification and subsequent disposition can be challenging. The original HEART score was derived as a predictive tool to risk stratify patients...
Contexts in source publication
Context 1
... modified HEART score (see Table 1) was introduced to incorporate the use of highly sensitive troponins and was retrospectively validated in a recent Chinese study [7]. It may complement MACE risk assessment and aid in decision-making for patients presenting to the emergency department with suspected ACS [6]. ...Similar publications
Objective:
Emergency physicians experience difficulty in determining the disposition of patients with elevated troponin I levels using emergency room tests. In this study, we aimed to investigate factors that could discriminate between the occurrence of type 1 myocardial infarction (T1MI) and type 2 myocardial infarction (T2MI) in patients with el...
Citations
Cardiovascular disease is one of the leading causes of death. The utility of the risk score in the emergency department is for the initial examination of patients with chest pain suspected of acute coronary syndrome. HEART score was developed in the Netherlands and utilized to stratify chest pain patients and classify the risk of the patients as well as to identify the possibility of Major Adverse Cardiac Event (MACE) occurrences in 6 weeks. This study aimed to compare STEMI and NSTEMI using the modified HEART score in chest pain patients at the Integrated Heart Center (PJT) Dr. Wahidin Sudirohusodo Government Hospital, Makassar. This study used a cross-sectional approach from January 1 to March 31, 2022. The sample was drawn from patients with chest pain clinically diagnosed NSTEMI or STEMI based on the medical records containing the procedure of initial examination and HEART score risk stratification of each patient. The HEART score was found to be statistically significantly higher in STEMI (7.0 and 7.3) than in NSTEMI (6.0 and 5.6) (p<0,001). AUC 0.809 (p<0.001). The cut-off value of the HEART score can be used as a predictor of STEMI/NSTEMI. A cut-off value of 5.5 and 6.5 (alternative) were obtained from the ROC curve and can provide optimal sensitivity and specificity. The higher the score appeared on the HEART score (high risk), the higher the number of STEMI diagnoses compared to NSTEMI diagnoses. This is characterized by a significant increase of Troponin-I. Hence, the HEART score can be used as a scoring measure to predict whether the patient will be diagnosed with NSTEMI or STEMI.
Unlabelled:
Despite being a frequent presenting complaint in emergency rooms, chest pain's clinical therapy varies greatly. Our objectives were to identify the traits of people who complain of chest pain and to analyze the value of the HEART (history, electrocardiogram, age, risk factors, and initial troponin) score index for risk assessment. Depending on how bad it is, each abnormality can be given a score of zero, one, or two points. These five factors add up to the HEART score.
Methods:
Clinical information on 269 individuals with chest pain admitted to the Emergency Room was reviewed: January 2022 until January 2023. A prospective registry was used to record information about patients with nontraumatic chest discomfort who were admitted from the emergency department.
Results:
Over a 12-month period, patients admitted in emergency department were classified through HEART score. From them 101 patients (37%) belong to the age group older than or equal to 65 years, 134 patients (50%) belong to the age group 45-65 years, and 34 patients (13%) belong to the age group younger than or equal to 45 years. Strong positive correlation between troponin level (HEART score) and hospitalization, also p value 0.043 is typically considered to be statistically significant. According to HEART score classification 43 cases (60%) from the group with 7-10 (high risk) were hospitalized. According to anamnesis (history) on cardiovascular disease in relation to hospitalization, then 48 cases hospitalized (67%) belong to the classification 1-moderately suspicious and 21 cases hospitalized (29%) belong to the classification 2-highly suspicious classification.
Conclusion:
The HEART score can be used for triage since it is a simple, rapid, and accurate predictor of outcome in patients with chest pain. A medium risk group included about half of the patients who reported chest pain to an emergency room. Hospitalization and troponin level had a strong positive link (HEART score), with a p value of 0.043.
