HEART Pathway

The HEART Pathway App: A validated clinical decision tool for patients presenting to the Emergency Room with Chest Pain.

Chest pain is a top cause of US ED visits. Eight to ten million patients with chest pain present to an ED annually in the United States. Emergency providers care for patients with chest pain on virtually every shift. More than half of Emergency Department patients with chest pain receive lengthy cardiac evaluations in an Chest Pain Unit or inpatient ward, with an annual cost $10-13 billion.

Less than ten percent of patients have an acute coronary syndrome (ACS). Two to five percent of patients with myocardial infarctions are inappropriately discharged from the ED every year. Missed ACS is a top cause of malpractice claims.

What is the HEART Pathway?

The HEART Pathway is designed for more accurate cardiac risk stratification for patients presenting to the ER with Chest Pain. The HEART Pathway is similar to the HEART score but has been modified by researchers at Wake Forest University School of Medicine.

The HEART Pathway has been validated by researchers at Wake Forest University School of Medicine and is used on a daily basis at Wake Forest and our affiliate Emergency Rooms.

Studies have demonstrated the benefits of the HEART Pathway compared to usual care. The HEART Pathway randomized control trial (Mahler et al, Circ CVQO J, 2015.) We have shown a more than $200 per patient cost savings when the HEART Pathway is utilized.

The HEART Pathway assists providers with answering the following questions:

Should I admit my patient for a stress testing or can I discharge my patient after two two negative troponins?

What is the likelihood that my patient’s presenting symptoms represent ACS?

What is the likelihood that my patient will have an ACS event in the near future (within 30 days)?