cliot (version 1.0.0)

he_macs_score: HE-MACS (History and ECG-only Manchester Acute Coronary Syndromes) Decision Aid

Description

Collects inputs for the HE-MACS decision aid, which stratifies the risk of Acute Coronary Syndrome (ACS) in patients presenting with chest pain using only history and ECG findings (no troponin required). It identifies "Very Low Risk" patients who may be candidates for early discharge.

Usage

he_macs_score(age, sex, smoker, systolic_bp_lt_100, ecg_ischemia,
              sweating_observed, vomiting, pain_radiation_right_arm)

Value

A list containing:

Risk_Model

Name of the model used.

Recommendation

General clinical guidance based on the HE-MACS stratification.

Inputs

List of patient parameters used for stratification.

Arguments

age

Numeric. Patient age in years.

sex

String. Patient sex ("Male" or "Female").

smoker

Numeric (0 or 1). Current tobacco smoker. (1 = Yes).

systolic_bp_lt_100

Numeric (0 or 1). Systolic Blood Pressure < 100 mmHg. (1 = Yes).

ecg_ischemia

Numeric (0 or 1). Acute ECG ischemia (e.g., ST depression, T-wave inversion). (1 = Yes).

sweating_observed

Numeric (0 or 1). Sweating observed by the clinician. (1 = Yes).

vomiting

Numeric (0 or 1). Vomiting associated with pain. (1 = Yes).

pain_radiation_right_arm

Numeric (0 or 1). Pain radiating to the right arm or shoulder. (1 = Yes).

References

Oliver G, Alghamdi A, Cameron S, et al. Enhanced triage for patients with suspected cardiac chest pain: the History and Electrocardiogram-only Manchester Acute Coronary Syndromes decision aid. Eur J Emerg Med. 2019;26(4):264-269. doi:10.1097/MEJ.0000000000000569

Examples

# Example 1: High Risk Factors
# 65yo Male, Smoker, Sweating, ECG Ischemia
he_macs_score(65, "male", 1, 0, 1, 1, 0, 0)

# Example 2: Low Risk Factors
# 40yo Female, No symptoms/signs other than chest pain
he_macs_score(40, "female", 0, 0, 0, 0, 0, 0)