Feasibility of Risk Stratification of Patients Presenting to the Emergency Department With Chest Pain Using HEART Score

We evaluated 141 patients presenting to the ED with chest pain concerning for ACS during the study period, from July 2019 to October 2019. Patients were 57.54 (13.13) years of age. The male to female distribution was 85 to 56. Other patient characteristics are shown in Table 2.

Primary outcomes

The risk stratification of the HEART score in chest pain patients and the incidence of 6-week MACE are outlined in Table 3 and Table 4, respectively.

The distribution of the HEART score’s 5 elements in the groups with or without MACE endpoints is shown in Table 5. Notice the significant differences between the groups. A follow-up phone call was made within 6 weeks after the presentation to the ED to assess the patient’s progress. The 6-week follow-up call data are included in Table 6.

Of 141 patients, 36 patients (25.53%) were diagnosed with MACE within 6 weeks of presentation. An AMI was diagnosed in 24 patients (17.02%). Coronary angiography was performed in 31 of 141 patients (21.99%), 15 patients (10.64%) underwent PCI, and 4 patients (2.84%) underwent CABG. The rest of the patients were treated with medications only.

Myocardial infarction—An AMI was diagnosed in 24 of the 141 patients (17.02%). Twenty-one of those already had positive markers on admission (apparently, these AMI had started before their arrival to the emergency room). One AMI occurred 2 days after admission in a 66-year-old male, and another occurred 10 days after discharge. A further AMI occurred 2 weeks after discharge. All 3 patients belonged to the intermediate-risk group.