SVEAT Score Calculator For Acute Chest Pain Risk Stratification
Identifies low-risk patients with acute chest pain, eligible for early and safe discharge.
Refer to the text below the calculator for more information on the score, its items and the research behind it.
The SVEAT score (Symptoms, Vascular disease history, Electrocardiography, Age, and Troponin level) is used to stratify the risk of major adverse cardiovascular events (MACE) in patients presenting with acute chest pain.
The score helps clinicians identify patients at low risk who can be safely discharged early and those at higher risk who may need further evaluation and treatment.
The SVEAT score varies from -6 to 15, where scores close to -6 mean a low risk of MACE and scores close to 15 indicate a high risk of major cardiac events. A cut off of 4 was proposed for risk of major adverse cardiovascular events.
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SVEAT score for acute chest pain
The SVEAT is a clinical decision rule that helps clinicians assess the risk of major adverse cardiovascular events (MACE) within 30 days in patients presenting with acute chest pain, guiding decisions on whether patients can be safely discharged or need further evaluation and treatment. The score incorporates various factors like symptoms, medical history, and test results to stratify risk effectively:
| SVEAT Score | Points | |
| Symptoms | Typical unstable angina pectoris | +3 |
| Stable angina, Canadian Cardiovascular Society Class I or II | +1 | |
| Non-cardiac chest pain | -2 | |
| History of vascular disease | Recent myocardial infarction or percutaneous coronary intervention < 90 days | +2 |
| Coronary artery bypass grafting > 5 years | +2 | |
| Prior coronary event other than above | +1 | |
| Prior revascularization for peripheral disease or carotid disease | +2 | |
| Electrocardiography (EKG) | Dynamic or new ischemic ST or T wave changes | +3 |
| ST depression of unknown duration without cause | +2 | |
| ST changes with left ventricular hypertrophy, intraventricular conduction delay, digitalis, or metabolic issue | +1 | |
| Old Q wave indicating prior myocardial infarction or pre-existing ST changes | +1 | |
| No ST changes | 0 | |
| Normal EKG in the presence of severe ongoing chest pain | -2 | |
| Age | >75 | +2 |
| 50 – 75 | +1 | |
| 30 – 49 | 0 | |
| <30 | -1 | |
| Troponin I (ng/mL) | 0.7 or higher | +5 |
| > 0.12 but < 0.7 | +2 | |
| > 0.04 but < or = 0.12 | +1 | |
| Normal (< or = 0.004) with unclear duration of chest pain | 0 | |
| Normal after > 4 h of constant chest pain | -2 | |
The SVEAT score ranges from -6 to 15, with scores near -6 indicating a low risk of major adverse cardiovascular events (MACE) and scores near 15 suggesting a high risk of significant cardiac events. A cut-off score of 4 has been suggested to evaluate the risk of MACE within 30 days.
Specifically, only 0.8% of patients with a score of 4 or less developed MACE, while higher scores indicate a greater risk.
About the original study
A 2020 study by Roongsritong et al. introduced the SVEAT score. It involved a cohort of 321 patients who presented to the emergency department with chest pain, followed for 30 days to track major cardiovascular events (MACE).
The SVEAT score outperformed the HEART and TIMI scores, with an area under the curve of 0.98, compared to 0.92 and 0.88, respectively. Using a cut-off score of 4, only 0.8% of patients developed a 30-day MACE, in contrast to 1.4% for HEART and 1.5% for TIMI. Additionally, the SVEAT score identified a higher proportion of low-risk patients (73.8%) compared to HEART (45.2%) and TIMI (40.1%).
Similarly, in a different study on another cohort of 330 patients with acute chest pain, conducted by Antwi-Amoabeng et al. the SVEAR score has demonstrated superior to the HEART score as a risk stratification tool for acute chest pain in low to intermediate risk patients.
Additional validation studies are needed to confirm the robustness and practical application of this tool for chest pain risk stratification in emergency department settings.
Chest pain clinical decision rules
A similar score to the SVEAT score for evaluating chest pain in the emergency room (ER) with the purpose to determine likelihood of major adverse cardiac events is the HEART score. The HEART score assesses the risk of MACE in patients with chest pain and includes five components: History, ECG (Electrocardiogram), Age, Risk factors, and Troponin levels. Each component is scored, and the total score helps guide clinical decisions on patient management, such as whether to admit the patient for further testing or to discharge them with appropriate follow-up.
The Emergency Department Assessment of Chest Pain Score (EDACS) is a clinical decision rule used to evaluate the risk of acute coronary syndrome (ACS) in patients presenting with chest pain in emergency departments
There are several scores that aim to assist in the evaluation of chest pain with simpler approaches, such as the Marburg Heart Score and the INTERCHEST Score that are mainly used in primary care for predicting likelihood of coronary artery events.
References
Original reference
Roongsritong C, Taha ME, Pisipati S, Aung S, Latt H, Thomas J, Namballa L, Al-Hasnawi HJ, Taylor MK, Gullapalli N. SVEAT Score, a Potential New and Improved Tool for Acute Chest Pain Risk Stratification. Am J Cardiol. 2020; 127:36-40.
Other references
Antwi-Amoabeng D, Roongsritong C, Taha M, Beutler BD, Awad M, Hanfy A, Ghuman J, Manasewitsch NT, Singh S, Quang C, Gullapalli N. SVEAT score outperforms HEART score in patients admitted to a chest pain observation unit. World J Cardiol. 2022; 14(8):454-461.
Shahid MF, Malik A, Kashif N, Siddiqi FA, Hammad M, Saeed HA. Risk Stratification of Acute-Onset Chest Pain: SVEAT Score Versus HEART and TIMI Scores. Cureus. 2023; 15(5):e39590.
Gol M, Bayram N, Demir O, Karacabey S, Sanri E. SVEAT score: Acute chest pain risk stratification. Am J Emerg Med. 2024; 80:24-28.
Specialty: Cardiology
System: Cardiovascular
Objective: Risk Stratification
Type: Score
No. Of Items: 5
Year Of Study: 2020
Article By: Denise Nedea
Published On: January 19, 2025
Last Checked: January 19, 2025
Next Review: January 19, 2030