The words chest pain get the immediate attention of clinicians in any practice setting, including urgent care. The question of calculating risk for a major event is not quite as clear-cut, however. One assessment tool, the HEART Score for Major Adverse Cardiac Events (MACE), has been validated to predict 6-week risk of major adverse cardiac events in patients 21 years of age and older presenting with symptoms suggestive of acute coronary syndrome. Michael Weinstock, MD, led a live discussion of the HEART Score with Barbra Backus, MD, PhD, creator of the HEART Score; and Erik Hess, MD, MSc, author of numerous articles on the use of shared decision making, during the recent Adena Chest Pain Summit 2018. Dr. Weinstock, the associate editor, clinical for JUCM is also the associate program director at the Adena Emergency Medicine Residency, director of medical education and Research for Adena Health System, and a professor of emergency medicine, adjunct at The Ohio State University College of Medicine. Their discussion, Calculating the HEART Score for the Advanced Clinician, is available for viewing here.