Title: The HEART score for ED patients with Chest Pain
题目：急诊科胸痛病人的HEART评分标准
Author 作者: Ali Farzad
 
The diagnosis of non-STE ACS can be difficult to exclude in ED patients with chest pain. Consequently, over-diagnosis and unnecessary treatment are common. Risk stratification tools (ie. TIMI, GRACE) have been created to help risk stratify ACS patients and predict mortality. However, they are of limited utility in the ED and do not effectively differentiate low to intermediate risk patients in all-comers with chest pain.  

 非ST段抬高的急性冠状动脉综合征（ACS）的诊断在急诊科胸痛患者中很难排除。因此，出现过度诊断和不必要的治疗是常见的。危险因素分析方法（如TIMI ， GRACE ）可以用来帮助分析风险因素和预测死亡率。然而，它们在急诊科的应用受到限制，并不能有效区分低和中度风险的所有胸痛患者。
 
The HEART score was recently prospectively validated in an ED population and was able to quickly and reliably predict risk of major adverse cardiac events (MACE - AMI, PCI, CABG, & Death). 

HEART评分最近在前瞻性急诊病人实验中得到了验证，它能够快速可靠地预测主要不良心脏事件发生的风险（严重心脏不良后果－MACE：急性心肌梗死， PCI，冠状动脉搭桥术，及死亡） 。

5 practical considerations (History, ECG, Age, Risk factors, & Troponin) are scored (0,1,or 2 points each) depending on the extent of the abnormality.
对5个实用的因素（History-病史，ECG-心电图，Age-年龄，Risk factors-危险因素，与Troponin-肌钙蛋白）进行评分，每一项根据异常的程度给0,1或2分。
A HEART score (0-10) can be quickly determined without complex calculations
HEART分数（ 0-10）可以不通过复杂的计算很快确定
Low scores (0-3) exclude short term MACE with >98% certainty
低分数（ 0-3）> 98 ％的可能性不会出现短期的MACE
High scores (7-10) have high (>50%) MACE rates
高分数（7-10 ）MACE发生率>50％
The HEART score performed significantly better than TIMI and GRACE scores 
HEART评分明显比TIMI和GRACE评分标准好
Bottom-line: The HEART score can help to objectively risk stratify ED patients with chest pain into low, intermediate, and high risk groups. Using the HEART score can also facilitate more efficient and effective communication with colleagues.
要点：HEART评分标准有助于将急诊科胸痛患者的风险客观地分为低，中，高风险人群组。使用HEART评分标准还可以方便与同事更快和有效的沟通。

References 参考文献：
Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. International Journal of Cardiology. 2013;168(3):2153–2158. 
Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008;16(6):191–196.