JC kicks off our 2018-2019 academic year by extending a warm welcome to our new interns and PA fellows. This month we are going to update a topic we reviewed in March of 2016 namely, utilization of the HEART score in the assessment of “low risk” chest pain patients. Our previous look at the topic included the original HEART derivation study as well as two validation studies which we will discuss briefly. Since then, there have been a host of additional studies that warrant a topic update (thanks Galen!)as well as a discussion regarding whether these current validation studies support broader adoption of the HEART score and how to apply it in our practice setting.  

ALL: Innes G.Successful hospitalization of patients with no discernible pathology.CJEM. 2000 Jan;2(1):47-51. 

Oliver JJ et al, An external validation of the HEART pathway among Emergency Department patients with chest pain. Intern Emerg Med. 2018 Mar 6.  

Stopyra JP et al. The HEART Pathway Randomized Controlled Trial One Year Outcomes. Acad Emerg Med. 2018 Jun 19.

Poldervaart JM et al. Comparison of the GRACE, HEART and TIMI score to predict major adverse cardiac events in chest pain patients at the emergency department. Int J Cardiol. 2017 Jan 15; 656-661.