HEART Score
Predicts 6-week risk of major adverse cardiac events in ED chest pain patients
- Highest activation tier
- Mandatory
- How it is scored
- Scored in code; a detected disagreeing draft value is flagged for correction
- Care settings
- Emergency department, Inpatient
When it activates
Scribeable activates a calculator from the encounter. The HEART Score can activate when the transcript or pasted chart context documents any of these:
- Chest pain evaluation in ED/urgent care
- ACS rule-out
- Disposition decision for chest pain
- Low-risk chest pain assessment
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: I20, I21, R07.
Note-type scope: it activates on notes whose subject resolves to cardiology, emergency medicine, critical care, hospital medicine. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
5 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| History suspiciousness for ACS | symptom |
| Clinical suspicion of the chest-pain history for ACS. |
| EKG abnormalities | exam |
| EKG findings on presentation. |
| Patient age | age | years | Scored 0 if <45, 1 if 45–64, 2 if ≥65. |
| Number of cardiac risk factors | history |
| HTN, hypercholesterolemia, DM, smoking, family history, obesity. |
| Initial troponin result | lab |
Scoring
History (0-2), EKG (0-2), Age (0-2), Risk factors (0-2), Troponin (0-2). Total 0-10.
History History suspiciousness for ACS + EKG EKG abnormalities + Age Patient age + Risk factors Number of cardiac risk factors + Troponin troponin
Interpretation
0-3: Low risk (0.9-1.7%), safe for discharge. 4-6: Moderate (12-16.6%), admission. >=7: High (50-65%), early invasive intervention.
Evidence
Sources carried in Scribeable's citation registry for this calculator.
- Six AJ et al. Chest pain in the emergency room: value of the HEART scoreSix et al. (HEART) 2008 · 2008 · Level I · link last verified 2026-03-23
How Scribeable handles it in the note
When an encounter activates the HEART Score at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.
The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a HEART Score value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.
Classified as a mandatory rule-out score: a missed result carries acute harm, so the activation filter never approves it on uncertainty.
See it activate on your own encounter
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