he_macs_score: HE-MACS (History and ECG-only Manchester Acute Coronary...

In cliot: Clinical Indices and Outcomes Tools

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)

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).

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.

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)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.