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How to Determine Your HEART Score and What it Means

August 30, 2018


You’re working out in the yard, and all of a sudden you feel short of breath. You also feel a little pain in your chest. You’re not sure what’s going on, so you head for the emergency department. Your doctor needs to make fast decisions to determine your path for treatment, so she begins adding up your HEART Score.

The HEART Score can help a cardiologist make diagnostic and therapeutic choices if you’re having chest pains. It’s typically used in an emergency department as an easy, quick and oftentimes reliable predictor of what should be done.

The HEART Score is actually the sum of five sections of a scorecard your doctor will use. The sections ask for the results of a test or other potential red flag. Each section can be scored with zero, one or two points, depending on the extent of your abnormality.

The reason it’s called the HEART Score is because each letter represents a section on the scorecard. Let’s look at the five factors doctors use to add up your heart score and what they mean.

The H in HEART Score Stands for History

Your medical history is a vital piece of information anytime you’re being seen by a doctor. Your doctor will begin asking specific questions, either of you or of other people who know you and can give suitable answers.

Based on the answers that are given, you will be given a HEART Score of:

  • 2 if the information is deemed highly suspicious
  • 1 if the information is deemed moderately suspicious
  • 0 if the information is deemed slightly or non-suspicious
  • 2 if you have a significant ST-deviation
  • 1 if you have a non-specific disturbance
  • 0 if your ECG is normal

The E in HEART Score Stands for ECG

ECG is short for electrocardiography. It is the process of recording the electrical activity of your heart over a period of time using electrodes placed on the skin.

On the monitor all you will see a line that moves as your heart beats. It tells your doctor things like:

  • ST-deviation: This is a fancy way to describe the flat line that comes just before a wave on the heart monitor. If your ST segment is abnormal, your heart is having trouble getting blood or you could already be having a heart attack.
  • Non-Specific Disturbances: This means something is going on, but you’re not having a heart attack.

Based on what the doctor sees, you will be given a HEART Score of:

The A in HEART Score Stands for Age

This one is pretty self-explanatory.

Based on your age, you will be given a HEART Score of:

  • 2 if you’re over age 65
  • 1 if your age is between 45 and 65
  • 0 if you’re less than 45 years old

The R in HEART Score Stands for Risk Factors

Risk factors is another one that’s pretty easy to figure out when adding up your HEART Score.

You will be given a HEART Score of:

  • 2 if you have more than three risk factors or have been treated for heart disease in the past
  • 1 if you have 1 or 2 risk factors for heart disease
  • 0 if you have no known risk factors

The T in HEART Score Stands for Troponin

Troponins are a family of proteins found in skeletal and heart muscle fibers. They produce muscular contraction. Troponin tests help detect heart injury. When there is damage to heart muscle cells, troponin is released into the blood.

Based on your troponin level, you will be given a HEART Score of:

  • 2 if it’s greater than 3 times the normal limit
  • 1 if it’s 1-3 times the normal limit
  • 0 if it’s at or below the normal limit

Adding Up Your HEART Score

So what does this all mean? Once your doctor has filled out each section of the scorecard, it will be added up. The type of treatment you receive will depend on that score.

If your HEART Score is 0-3: you will most likely be discharged

If your HEART Score is 4-6: you will most likely be admitted to the hospital.

If your HEART Score is 7 or greater: you will most likely be given early invasive measures.

The HEART Score will objectively classify you into a low-, moderate- or high-risk category. This will help guide treatment. It can even lead to shorter hospital and Emergency Department stays for low-risk patients, and earlier interventions for moderate and high-risk patients.

If you’re hoping to avoid ever having to find out your HEART Score download our guide “Heart Disease Facts That Could Change Your Life”. In it you’ll find the risk factors for heart disease that should matter most to you and help you steer clear of America’s number one killer.

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