ACS · LIVE

Marburg Heart Score

MHS

Sum the five Bösner 2010 Marburg Heart Score determinants and return the published positive (3–5) or negative (≤2) cut-off.

LIVE $0.005 USDC GET /api/calc/mhs

Markdown: /docs/mhs.md · Canonical: https://magentlab.com/docs/mhs

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Sum the five Bösner 2010 Marburg Heart Score determinants and return the published positive (3–5) or negative (≤2) cut-off.

When to use

When an agent needs the published primary-care MHS total and must not invent the four findings or treat the score as an ED ACS rule-out.

When not to use

Not a medical device.
Primary-care chest-pain rule only (Bösner 2010). Not an ACS rule-out in the emergency department.
Not a diagnosis or admission order.
The caller assigns the four clinical flags. magent does not interview the patient.

Formula

MHS = age_sex (female ≥65 or male ≥55) + known_vascular_disease + assumes_cardiac_origin + pain_worse_exercise + pain_not_reproducible; each 1; max 5; positive 3–5, negative ≤2 (Bösner 2010 Table 3)

Citation

Title: Ruling out coronary artery disease in primary care: development and validation of a simple prediction rule
Authors: Bösner S, Haasenritter J, Becker A, Karatolios K, Vaucher P, Gencer B, Herzig L, Heinzel-Gutenbrunner M, Schaefer JR, Abu Hani M, Keller H, Sönnichsen AC, Baum E, Donner-Banzhoff N
Source: CMAJ. 2010;182(12):1295-1300
DOI: 10.1503/cmaj.100212

Worked example

Age 40 female, all flags false

Given: age=40assumes_cardiac_origin=falseknown_vascular_disease=falsepain_not_reproducible=falsepain_worse_exercise=falsesex=female

Female 40 is not ≥65 → 0; four flags false → 0 each
Score = 0 (max 5); mhs_result negative (≤2)

Three flags present (published positive cut-off)

Given: age=40assumes_cardiac_origin=trueknown_vascular_disease=truepain_not_reproducible=falsepain_worse_exercise=truesex=female

Female 40 → 0; three flags true → 3
Score = 3 (max 5); mhs_result positive (3–5)

Also searched as

Marburg Heart Score
MHS score
Bösner prediction rule
primary care CAD rule
chest pain primary care score
Marburg score coronary
Bösner 2010 chest pain

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/mhs?age=40&sex=female&known_vascular_disease=false&assumes_cardiac_origin=false&pain_worse_exercise=false&pain_not_reproducible=false

Full URL: https://api.magentlab.com/api/calc/mhs?age=40&sex=female&known_vascular_disease=false&assumes_cardiac_origin=false&pain_worse_exercise=false&pain_not_reproducible=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/mhs?age=40&sex=female&known_vascular_disease=false&assumes_cardiac_origin=false&pain_worse_exercise=false&pain_not_reproducible=false"

Parameters

Name	Type	Required	Description
`age`	integer	required	Age in years (18-120). Combined with sex: female ≥65 or male ≥55 scores 1 (Bösner 2010 Table 3). magent computes this; do not send a precomputed flag.
`sex`	string	required · female, male	female or male. Combined with age: female ≥65 or male ≥55 scores 1 (Bösner 2010 Table 3).
`known_vascular_disease`	boolean	required	Known clinical vascular disease: coronary, cerebrovascular, or peripheral (Bösner 2010). true or false as assigned by the caller.
`assumes_cardiac_origin`	boolean	required	Patient assumes the pain is of cardiac origin (Bösner 2010). true or false as assigned by the caller. magent does not interview the patient.
`pain_worse_exercise`	boolean	required	Pain worse with exercise (Bösner 2010). true or false as assigned by the caller.
`pain_not_reproducible`	boolean	required	Pain is not reproducible by palpation (Bösner 2010). true when that published finding is present; false if pain is reproducible. Assigned by the caller.

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/mhs Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

1 to 25 items. Each item uses the same keys as the GET query parameters.
POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "age": "40",
      "assumes_cardiac_origin": "false",
      "known_vascular_disease": "false",
      "pain_not_reproducible": "false",
      "pain_worse_exercise": "false",
      "sex": "female"
    },
    {
      "age": "40",
      "assumes_cardiac_origin": "false",
      "known_vascular_disease": "false",
      "pain_not_reproducible": "false",
      "pain_worse_exercise": "false",
      "sex": "female"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/mhs",
  "items": [
    {
      "components": [
        {
          "value": 40,
          "factor": "age_sex",
          "points": 0,
          "present": false
        },
        {
          "factor": "known_vascular_disease",
          "points": 0,
          "present": false
        },
        {
          "factor": "assumes_cardiac_origin",
          "points": 0,
          "present": false
        },
        {
          "factor": "pain_worse_exercise",
          "points": 0,
          "present": false
        },
        {
          "factor": "pain_not_reproducible",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Bösner S, Haasenritter J, Becker A, Karatolios K, Vaucher P, Gencer B, Herzig L, Heinzel-Gutenbrunner M, Schaefer JR, Abu Hani M, Keller H, Sönnichsen AC, Baum E, Donner-Banzhoff N",
        "doi": "10.1503/cmaj.100212",
        "id": "bosner-2010",
        "pmid": "20603345",
        "source": "CMAJ. 2010;182(12):1295-1300",
        "title": "Ruling out coronary artery disease in primary care: development and validation of a simple prediction rule"
      },
      "formula": "mhs",
      "formula_expression": "MHS = age_sex (female ≥65 or male ≥55) + known_vascular_disease + assumes_cardiac_origin + pain_worse_exercise + pain_not_reproducible; each 1; max 5; positive 3–5, negative ≤2 (Bösner 2010 Table 3)",
      "age_years": 40,
      "max_score": 5,
      "score": 0,
      "sex": "female",
      "mhs_result": "negative"
    },
    {
      "components": [
        {
          "value": 40,
          "factor": "age_sex",
          "points": 0,
          "present": false
        },
        {
          "factor": "known_vascular_disease",
          "points": 0,
          "present": false
        },
        {
          "factor": "assumes_cardiac_origin",
          "points": 0,
          "present": false
        },
        {
          "factor": "pain_worse_exercise",
          "points": 0,
          "present": false
        },
        {
          "factor": "pain_not_reproducible",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Bösner S, Haasenritter J, Becker A, Karatolios K, Vaucher P, Gencer B, Herzig L, Heinzel-Gutenbrunner M, Schaefer JR, Abu Hani M, Keller H, Sönnichsen AC, Baum E, Donner-Banzhoff N",
        "doi": "10.1503/cmaj.100212",
        "id": "bosner-2010",
        "pmid": "20603345",
        "source": "CMAJ. 2010;182(12):1295-1300",
        "title": "Ruling out coronary artery disease in primary care: development and validation of a simple prediction rule"
      },
      "formula": "mhs",
      "formula_expression": "MHS = age_sex (female ≥65 or male ≥55) + known_vascular_disease + assumes_cardiac_origin + pain_worse_exercise + pain_not_reproducible; each 1; max 5; positive 3–5, negative ≤2 (Bösner 2010 Table 3)",
      "age_years": 40,
      "max_score": 5,
      "score": 0,
      "sex": "female",
      "mhs_result": "negative"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	mhs
`formula_expression`	string	Exact expression used
`score`	integer	MHS points 0-5
`max_score`	integer	5
`mhs_result`	string	Published Bösner 2010 discrimination cut-off: positive (3-5) or negative (≤2). Not a diagnosis or admission order.
`sex`	string	female or male used with age for the age/sex determinant
`age_years`	integer	Age used with sex for the age/sex determinant
`components`	array	Per-determinant points
`citation`	object	Bösner et al. CMAJ 2010 citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "value": 40,
      "factor": "age_sex",
      "points": 0,
      "present": false
    },
    {
      "factor": "known_vascular_disease",
      "points": 0,
      "present": false
    },
    {
      "factor": "assumes_cardiac_origin",
      "points": 0,
      "present": false
    },
    {
      "factor": "pain_worse_exercise",
      "points": 0,
      "present": false
    },
    {
      "factor": "pain_not_reproducible",
      "points": 0,
      "present": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Bösner S, Haasenritter J, Becker A, Karatolios K, Vaucher P, Gencer B, Herzig L, Heinzel-Gutenbrunner M, Schaefer JR, Abu Hani M, Keller H, Sönnichsen AC, Baum E, Donner-Banzhoff N",
    "doi": "10.1503/cmaj.100212",
    "id": "bosner-2010",
    "pmid": "20603345",
    "source": "CMAJ. 2010;182(12):1295-1300",
    "title": "Ruling out coronary artery disease in primary care: development and validation of a simple prediction rule"
  },
  "formula": "mhs",
  "formula_expression": "MHS = age_sex (female ≥65 or male ≥55) + known_vascular_disease + assumes_cardiac_origin + pain_worse_exercise + pain_not_reproducible; each 1; max 5; positive 3–5, negative ≤2 (Bösner 2010 Table 3)",
  "age_years": 40,
  "max_score": 5,
  "score": 0,
  "sex": "female",
  "mhs_result": "negative"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_age`	age must be an integer from 18 to 120 Returned before settlement; you are not charged.
400	`invalid_sex`	sex must be female or male Returned before settlement; you are not charged.
400	`invalid_flag`	boolean clinical flags must be true or false Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

HEART score — Compute the HEART score as age points plus caller-assigned history, ECG, risk factors, and troponin (each 0-2).
EDACS — Compute the Than 2014 Emergency Department Assessment of Chest pain Score from age, sex, and caller-assigned flags.

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
Execution is timeout-bounded and concurrency-capped.
Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.