{
  "abstract": "Background: Most patients admitted for chest pain rule-out for acute coronary syndrome yet undergo low-value inpatient testing that prolongs stay and consumes scarce community-hospital resources.\n\nProject Rationale: Baseline review showed utilization misaligned with HEART (History, Electrocardiogram, Age, Risk factors, Troponin)-derived risk and inconsistent, upwardly inflated score documentation, indicating the need for a standardized discharge pathway.\n\nProject Summary: Among 156 emergency department chest-pain encounters (0% 6-week major adverse cardiac events), 89% received cardiology consultation and 45% echocardiography (88% normal); 44% of documented HEART scores were inflated. We adopted the HEART Score-Guided Accelerated Discharge Protocol: mandatory same-admission cardiology consult, indication-only echocardiography, no reflexive labs, target discharge under 24 hours, and guaranteed follow-up, with prespecified measures and an approximate cost avoidance of $120,000 (about $1,000 per patient) per rule-out cohort.\n\nTake-Home Message: A simple, electronic medical record–free HEART-guided pathway can safely reduce low-value testing and redirect scarce resources to higher-acuity patients.",
  "abstract_shown": true,
  "affiliations": [
    "Landmark Medical Center, Department of Internal Medicine, Woonsocket, Rhode Island, USA",
    "Landmark Medical Center, Department of Cardiology, Woonsocket, Rhode Island, USA"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Abdul Allam Khan"
    },
    {
      "affs": [
        0
      ],
      "name": "Huzaifa Rashid"
    },
    {
      "affs": [
        0
      ],
      "name": "Jenna Iannuccilli"
    },
    {
      "affs": [
        1
      ],
      "name": "Ibrahim Elgarby"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0r1tn3nw8rfbx.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jaccas.2026.109660",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13728261/",
  "id": "0r1tn3nw8rfbx",
  "issns": [
    "2666-0849"
  ],
  "landing_url": "https://doi.org/10.1016/j.jaccas.2026.109660",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Outcomes and Quality"
    ],
    [
      "heading",
      "Quality Improvement Projects"
    ],
    [
      "openalex",
      "3600|Healthcare cost, quality, practices"
    ]
  ],
  "openalex": "W7213395531",
  "pdf_url": null,
  "pmcid": "PMC13728261",
  "pmid": "42752017",
  "published": "2026-09-16",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/0r1tn3nw8rfbx.ris",
  "sources": [
    {
      "first_seen": "2026-11-06T12:23:58Z",
      "native_id": "PMC13728261",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jaccas.2026.109660"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2705|Cardiac Valve Diseases and Treatments",
      "subfield": "cardiovascular"
    }
  ],
  "title": "HEART Score-Guided Accelerated Discharge for Patients Admitted With Chest Pain",
  "title_text": "HEART Score-Guided Accelerated Discharge for Patients Admitted With Chest Pain",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:17Z",
  "url": "https://research.draconitic.com/paper/0r1tn3nw8rfbx",
  "venue": "JACC Case Reports",
  "versions": []
}