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Peer-reviewedCC BY-NC-ND 4.0JACC Case Reports

HEART Score-Guided Accelerated Discharge for Patients Admitted With Chest Pain

  • Abdul Allam Khan1
  • Huzaifa Rashid1
  • Jenna Iannuccilli1
  • Ibrahim Elgarby2
  1. 1Landmark Medical Center, Department of Internal Medicine, Woonsocket, Rhode Island, USA
  2. 2Landmark Medical Center, Department of Cardiology, Woonsocket, Rhode Island, USA
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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.

Project 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.

Project 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.

Take-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.

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Cite

BibTeXRIS
BibTeX
@article{khan2026heart,
  title = {{HEART Score-Guided Accelerated Discharge for Patients Admitted With Chest Pain}},
  author = {Abdul Allam Khan and Huzaifa Rashid and Jenna Iannuccilli and Ibrahim Elgarby},
  journal = {JACC Case Reports},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jaccas.2026.109660},
  url = {https://doi.org/10.1016/j.jaccas.2026.109660},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - HEART Score-Guided Accelerated Discharge for Patients Admitted With Chest Pain
AU  - Abdul Allam Khan
AU  - Huzaifa Rashid
AU  - Jenna Iannuccilli
AU  - Ibrahim Elgarby
PY  - 2026
DA  - 2026/09/16
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.109660
UR  - https://doi.org/10.1016/j.jaccas.2026.109660
AB  - 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.  Project 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.  Project 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.  Take-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.
SN  - 2666-0849
ER  -