Medical Calculators for Cardiology

Both estimate 10-year risk of a first major cardiovascular event. The Pooled Cohort Equations (ASCVD, 2013 ACC/AHA) includes African American race as a variable and predicts fatal or non-fatal MI or stroke. The Framingham Risk Score (2008) predicts coronary heart disease events. ASCVD is now the preferred tool per current ACC/AHA guidelines. Both are most accurate in patients without established CVD.

The HEART score (History, ECG, Age, Risk factors, Troponin) is designed for undifferentiated chest pain in the ED and stratifies 6-week MACE risk. HEART 0–3: low risk (<2%), safe for early discharge. HEART 4–6: moderate, admission warranted. HEART 7–10: high, early intervention likely beneficial. TIMI scores are for diagnosed NSTEMI (TIMI-NSTEMI) or STEMI (TIMI-STEMI) to guide reperfusion strategy, not initial triage.

ABI is the ratio of ankle systolic pressure to brachial systolic pressure. Normal: 1.0–1.4. Borderline PAD: 0.91–0.99. Mild PAD: 0.7–0.9. Moderate PAD: 0.4–0.69. Severe PAD: <0.4. ABI >1.4 suggests arterial incompressibility (calcification), common in diabetes. Symptomatic patients with borderline or low ABI warrant vascular surgery referral.

GRACE (Global Registry of Acute Coronary Events) uses age, heart rate, systolic BP, creatinine, Killip class, cardiac arrest at admission, ST deviation, and troponin to predict in-hospital and 6-month mortality. Low risk: <108 (in-hospital mortality <1%). Intermediate: 109–140 (1–3%). High: >140 (>3%). High GRACE score supports early invasive strategy in NSTEMI.

NYHA Class I–IV characterizes heart failure symptom severity: Class I = no symptoms with ordinary activity; Class II = mild symptoms with moderate exertion; Class III = symptoms with minimal exertion; Class IV = symptoms at rest. NYHA class guides therapy escalation, device therapy eligibility (ICD/CRT typically for Class II–III with EF ≤35%), and prognosis conversations.