Do you pursue stress testing before discharge for a patient admitted with chest pain who has negative serial high-sensitivity troponins and a low HEART score?

I usually do not since the HEART score (0-3) has such a low incidence of cardiac events in 6 weeks, and in the study, those patients were discharged. That being said, I would ensure the patient has a follow-up within a week to set up any testing that you feel is necessary to work up the chest pain.

Always test an admission for chest pain. Do not put so much faith in analytic scoring.

If a low-risk patient is up and about on the unit and able to ambulate around the unit several laps while still on telemetry, I discharge to OP care and further risk stratify with either a nuclear stress test or stress echo. Otherwise, cardiac cath prior to discharge.