The risk stratification of adult patients with acute chest pain and the proportion of major adverse cardiac events among the low-risk group presenting to the emergency department

Abstract

Background & Aims: The aim of the study was to assess the safety of the HEAR Score for the early disposition of patients with chest pain presenting to the Emergency Department (ED). Materials & Methods: A total of 316 adult patients presenting with low-risk, acute-onset chest pain were included. The HEAR Score was applied to those with non-ST elevation myocardial infarction (NSTEMI), unstable angina, and other causes of chest pain, using ECG analysis and patient history. Results: Among the patients, 71.2% were male, and the majority were aged 45-65. Key findings included 21.2% with nonspecific ECG abnormalities and 19.9% with ST depression. A total of 1.9% experienced major adverse cardiovascular events (MACE). No significant associations were found between MACE and age, risk factors, or ECG scores. The average hospital stay was 4.5 hr, after which most patients were discharged for further testing. Conclusion: Our study showed that the incidence of MACE in low-risk chest pain patients was only 1.9%, and the mean hospital stay duration was only 4.5 hr with the application of the HEAR Score. Further studies are needed to validate the HEAR Score in the Indian population. It may be used by ED physicians to guide the management of low-risk chest pain patients.

Keywords

• acute chest pain
• echocardiogram
• hear score
• non-st elevation myocardial infarction