Evaluating the Usefulness of HEAR Score in Stratifying Patients with Suspected Non-ST Elevation Myocardial Infarction: A Retrospective Observational Study

Background: Chest pain is the common reason for admissions to the cardiac emergency department. The challenge is identifying patients with acute coronary syndrome (ACS), where early diagnosis improves outcomes. Based on history, EKG, age, and risk factors, the HEAR score assigns 0-2 points per category. Objectives: To evaluate the usefulness of HEAR SCORE in stratifying patients with suspected Non-ST Elevation Myocardial Infarction (NSTEMI). Method: This retrospective observational study included 195 patients presenting chest pain and suspected NSTEMI at the Department of Emergency Medicine, KIMSHEALTH, Thiruvananthapuram. The outcomes were observed, and the HEAR scores were subsequently applied. Results: A majority (65%) of patients with a HEAR score of 3were discharged.Patients with scores 4 to 6 HEAR (75%) were admitted and evaluated in the hospital.In the 7 group, 60.5% received early intervention.The HEAR scores for discharge, Hospital admission, evaluation, and early intervention are 2.9000, 4.8018, and 6.6591, respectively.These differences are statistically significant with p-value less than < 0.001.The sensitivity and specificity of a HEAR score greater than 3 for hospitalization are 91% and 65%, respectively.Conclusion: HEAR score effectively stratifies NSTEMI risk, minimizing unnecessary Troponin tests and admissions using a 3 cutoff strategy.