Importance of Heart Score For Chest Pain Patients Presenting To Emergency Department In The Absence Of Stemi
DOI:
https://doi.org/10.64149/Keywords:
Chest pain; HEART score; Acute coronary syndrome; Emergency department; Risk stratification; Patient outcome.Abstract
Background: Chest pain is one of the most common presentations to the emergency department (ED), and the diagnosis of non–ST elevation acute coronary syndrome (ACS) often causes uncertainty. The HEART score is designed to differentiate high-risk and low-risk chest pain patients and serves as an easy, quick, and reliable predictor of outcome rather than mere risk differentiation. In current practice, nearly 60% of chest pain patients have no clear ACS presentation, leading to delayed decision-making and unnecessary hospital admissions. The challenge in the ED is not only to identify high-risk patients but also to safely discharge low-risk patients.
Aim:
- To differentiate high-risk and low-risk patients presenting with chest pain to the ED.
- To predict patient outcomes using the HEART score in chest pain patients presenting to the ED.
Methods: This prospective study included 200 patients presenting with chest discomfort to the emergency department of PRS Hospital, Kilipalam, Trivandrum, between November 2018 and October 2019. All patients above 18 years presenting with chest pain in the absence of STEMI were included. HEART score was calculated at the time of ED arrival and patients were categorized into high-risk and low-risk groups. Patients were followed up after three days, and various prognostic indicators were recorded. Data were analyzed using SPSS software to evaluate the association between HEART score and patient outcomes.
Results: The mean HEART score among patients who required cardiac interventional strategies was 6. HEART score calculated at ED admission showed a strong statistical correlation with patient outcomes. A significant association was observed between HEART score and increasing age, need for PCI, mortality, and duration of hospital stay (p < 0.005). HEART score was significantly correlated with overall patient outcome.
Conclusion: The HEART score assists physicians in making accurate diagnostic and therapeutic decisions in chest pain patients without ST-elevation myocardial infarction. It is an easy, quick, and reliable predictor of outcome and can be effectively used for triage and risk stratification in the emergency department.
