HEAR Score
Stratifies the risk of NSTEMI and evaluates the necessity of troponin measurement.
This tool is similar to the HEART Score and HEART Pathway but does not include troponin; use it when a patient is suspected to be at very low risk for acute coronary syndrome (ACS).
Advice
Meeting the “very low risk” threshold does not constitute “zero risk”; pair results with clinical judgment and local protocols.
Management
- Score ≤1 (with nonischemic ECG and no known CAD):
- Suggests very low risk for MACE.
- Troponin testing may be avoided, or single troponin testing may be appropriate (depending on local protocols).
- Patients who are discharged should be provided clear return precautions.
- Score ≥2 (or any concern for ACS): Proceed with HEART Score/HEART Pathway and standard ACS evaluation.