cliot (version 1.0.0)

marburg_heart_score: Marburg Heart Score (MHS)

Description

Calculates the Marburg Heart Score to rule out coronary artery disease (CAD) in primary care patients presenting with chest pain. The score stratifies patients into low, intermediate, or high probability of having significant CAD based on five clinical predictors.

Usage

marburg_heart_score(age, sex, history_vascular_disease, patient_suspects_cardiac,
                    pain_worsens_exercise, pain_not_reproducible)

Value

A list containing:

MHS_Score

The calculated score (Range 0-5).

Risk_Category

Classification (Low 0-2, Intermediate 3, High 4-5).

CAD_Probability

Estimated probability of significant Coronary Artery Disease.

Arguments

age

Numeric. Patient age in years.

sex

String. Patient sex ("Male" or "Female"). (Score adds 1 point if Male >= 55 or Female >= 65).

history_vascular_disease

Numeric (0 or 1). Known atherosclerosis, including Coronary Artery Disease, Cerebrovascular Disease, or Peripheral Arterial Disease. (1 = Yes, +1 point).

patient_suspects_cardiac

Numeric (0 or 1). Does the patient assume the pain is of cardiac origin? (1 = Yes, +1 point).

pain_worsens_exercise

Numeric (0 or 1). Does the pain worsen with exercise? (1 = Yes, +1 point).

pain_not_reproducible

Numeric (0 or 1). Is the pain NOT reproducible by palpation? (1 = Yes/Not Reproducible, +1 point. Note: If pain IS reproducible, enter 0).

References

Bosner S, Becker A, Haasenritter J, et al. Chest pain in primary care: epidemiology and pre-work-up probabilities. Eur J Gen Pract. 2009;15(3):141-146. Haasenritter J, Bösner S, Vaucher P, et al. Ruling out coronary heart disease in primary care: external validation of a clinical prediction rule. CMAJ. 2012;184(3):E149-E157. doi:10.1503/cmaj.110960

Examples

# Example 1: High Risk
# 60yo Male (+1), Vascular Hx (+1), Suspects Cardiac (+1), Exertional (+1), Not Reproducible (+1)
# Score = 5
marburg_heart_score(60, "male", 1, 1, 1, 1)

# Example 2: Low Risk
# 40yo Female (0), No Hx, Reproducible pain (Input 0 for 'not reproducible')
# Score = 0
marburg_heart_score(40, "female", 0, 0, 0, 0)