Using the HEART Score in Patients With Chest Pain in the Emergency Department
Authors: Thomas Moumneh, Delphine Douillet, Pierre-Marie Roy
Journal: Annals of Internal Medicine (2017)

Letters7 November 2017Using the HEART Score in Patients With Chest Pain in the Emergency DepartmentThomas Moumneh, MD, Delphine Douillet, MD, and Pierre-Marie Roy, MD, PhDThomas Moumneh, MDFrom Centre Hospitalier Universitaire d'Angers, Angers, France.Search for more papers by this author, Delphine Douillet, MDFrom Centre Hospitalier Universitaire d'Angers, Angers, France.Search for more papers by this author, and Pierre-Marie Roy, MD, PhDFrom Centre Hospitalier Universitaire d'Angers, Angers, France.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0435 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Poldervaart and colleagues (1) confirmed the safety of the HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score, proving noninferiority versus usual care with a difference in the incidence of major adverse cardiac events of −1.3%. As such, patients with chest pain and a score less than 4 based on 5 criteria that are each worth between 0 and 2 points could safely be discharged early from the emergency department. Their study suggests that implementing the HEART score is cost-effective; however, they do not show a significant difference in the use of health care resources, especially ...References1. Poldervaart JM, Reitsma JB, Backus BE, Koffijberg H, Veldkamp RF, Ten Haaf ME, et al. Effect of using the HEART score in patients with chest pain in the emergency department: a stepped-wedge, cluster randomized trial. Ann Intern Med. 2017;166:689-97. [PMID: 28437795]. doi:10.7326/M16-1600 LinkGoogle Scholar2. Chaou CH, Chen HH, Chang SH, Tang P, Pan SL, Yen AM, et al. Predicting length of stay among patients discharged from the emergency department—using an accelerated failure time model. PLoS One. 2017;12:e0165756. [PMID: 28107348] doi:10.1371/journal.pone.0165756 CrossrefMedlineGoogle Scholar3. Zhelev Z, Hyde C, Youngman E, Rogers M, Fleming S, Slade T, et al. Diagnostic accuracy of single baseline measurement of Elecsys Troponin T high-sensitive assay for diagnosis of acute myocardial infarction in emergency department: systematic review and meta-analysis. BMJ. 2015;350:h15. [PMID: 25646632] doi:10.1136/bmj.h15 CrossrefMedlineGoogle Scholar4. Singh B, Mommer SK, Erwin PJ, Mascarenhas SS, Parsaik AK. Pulmonary Embolism Rule-out Criteria (PERC) in pulmonary embolism—revisited: a systematic review and meta-analysis. Emerg Med J. 2013;30:701-6. [PMID: 23038695] doi:10.1136/emermed-2012-201730 CrossrefMedlineGoogle Scholar5. Interest of CARE rule to exclude the hypothesis of an acute coronary syndrome without bioassay—ICARE (ICARE). ClinicalTrials.gov: NCT02813499. Accessed at https://clinicaltrials.gov/ct2/show/NCT02813499 on 19 September 2017. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Centre Hospitalier Universitaire d'Angers, Angers, France.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0435. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Using the HEART Score in Patients With Chest Pain in the Emergency Department Judith M. Poldervaart , Johannes B. Reitsma , Barbra E. Backus , Hendrik Koffijberg , Rolf F. Veldkamp , Monique E. ten Haaf , Yolande Appelman , Herman F.J. Mannaerts , Jan-Melle van Dantzig , Madelon van den Heuvel , Mohamed el Farissi , Bernard J.W.M. Rensing , Nicolette M.S.K.J. Ernst , Ineke M.C. Dekker , Frank R. den Hartog , Thomas Oosterhof , Ghizelda R. Lagerweij , Eugene M. Buijs , Maarten W.J. van Hessen , Marcel A.J. Landman , Roland R.J. van Kimmenade , Luc Cozijnsen , Jeroen J.J. Bucx , Clara E.E. van Ofwegen-Hanekamp , Maarten-Jan Cramer , A. Jacob Six , Pieter A. Doevendans , and Arno W. Hoes Using the HEART Score in Patients With Chest Pain in the Emergency Department Judith M. Poldervaart , Johannes B. Reitsma , Jacob Six , Rolf F. Veldkamp , and Arno W. Hoes Metrics 7 November 2017Volume 167, Issue 9Page: 687-688KeywordsAcute coronary syndromeElectrocardiographyEmergency departmentHealth careHeartIschemiaMedical risk factorsPulmonary embolismSafetyTroponin ePublished: 7 November 2017 Issue Published: 7 November 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...