ACS · LIVE

Vancouver Chest Pain Rule

Apply the Christenson 2006 Vancouver Chest Pain Rule derivation tree and return whether caller-assigned ECG, 2-hour troponin, prior ACS or nitrate, palpation, age, and radiation nodes are early-discharge eligible.

LIVE $0.005 USDC GET /api/calc/vancouver_chest_pain

Markdown: /docs/vancouver-chest-pain.md · Canonical: https://magentlab.com/docs/vancouver-chest-pain

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

What it computes

Apply the Christenson 2006 Vancouver Chest Pain Rule derivation tree and return whether caller-assigned ECG, 2-hour troponin, prior ACS or nitrate, palpation, age, and radiation nodes are early-discharge eligible.

When to use

When an agent already has caller-assigned flags for an abnormal initial ECG, 2-hour troponin elevation, prior ACS or nitrate use, pain reproduced by palpation, and radiation to neck, arm, or jaw, plus age in years, and needs the published 2006 early-discharge-eligible result. magent does not interpret an ECG or assay troponin. Not the later age-50 variant.

When not to use

• Not a medical device and not a diagnosis of ACS.
• Not a discharge, observation, or provocative-testing order.
• abnormal_initial_ecg, troponin_2h_elevated, prior_acs_or_nitrate, palpation_reproduces_pain, and pain_radiates_neck_jaw_arm are caller-assigned. magent does not interpret ECGs, palpate the chest, or assay troponin or CK-MB.
• This tool is the Christenson 2006 derivation tree with age under 40 on the age-history path. Age 40 is not that path. Not the Cullen 2014 or Scheuermeyer 2014 age-50 variant.
• The 2006 derivation used CK-MB on the age ≥40 branch; this tool takes a caller-assigned 2-hour troponin flag at that biomarker node.

Formula

early_discharge_eligible iff not abnormal_initial_ecg and not troponin_2h_elevated and not prior_acs_or_nitrate and (palpation_reproduces_pain or (age < 40 and not pain_radiates_neck_jaw_arm)); age 40 is not the age-history path (Christenson 2006 derivation tree; not Cullen 2014 / Scheuermeyer 2014 age 50)

Citation

Title

A clinical prediction rule for early discharge of patients with chest pain

Authors

Christenson J, Innes G, McKnight D, et al.

Source

Ann Emerg Med. 2006;47(1):1-10

DOI

10.1016/j.annemergmed.2005.08.007

Worked example

Also searched as

• Vancouver Chest Pain Rule
• Christenson 2006
• VCPR
• early discharge chest pain
• Vancouver chest pain
• Christenson Innes McKnight
• 2-hour chest pain rule

Try

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

/api/calc/vancouver_chest_pain?age=35&abnormal_initial_ecg=false&troponin_2h_elevated=false&prior_acs_or_nitrate=false&palpation_reproduces_pain=false&pain_radiates_neck_jaw_arm=false

Full URL: https://api.magentlab.com/api/calc/vancouver_chest_pain?age=35&abnormal_initial_ecg=false&troponin_2h_elevated=false&prior_acs_or_nitrate=false&palpation_reproduces_pain=false&pain_radiates_neck_jaw_arm=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/vancouver_chest_pain?age=35&abnormal_initial_ecg=false&troponin_2h_elevated=false&prior_acs_or_nitrate=false&palpation_reproduces_pain=false&pain_radiates_neck_jaw_arm=false"

Parameters

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/vancouver_chest_pain 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": [
    {
      "abnormal_initial_ecg": "false",
      "age": "35",
      "pain_radiates_neck_jaw_arm": "false",
      "palpation_reproduces_pain": "false",
      "prior_acs_or_nitrate": "false",
      "troponin_2h_elevated": "false"
    },
    {
      "abnormal_initial_ecg": "false",
      "age": "35",
      "pain_radiates_neck_jaw_arm": "false",
      "palpation_reproduces_pain": "false",
      "prior_acs_or_nitrate": "false",
      "troponin_2h_elevated": "false"
    }
  ]
}

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/vancouver_chest_pain",
  "items": [
    {
      "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": "Christenson J, Innes G, McKnight D, et al.",
        "doi": "10.1016/j.annemergmed.2005.08.007",
        "id": "christenson-2006",
        "pmid": "16387209",
        "source": "Ann Emerg Med. 2006;47(1):1-10",
        "title": "A clinical prediction rule for early discharge of patients with chest pain"
      },
      "formula": "vancouver_chest_pain",
      "formula_expression": "early_discharge_eligible iff not abnormal_initial_ecg and not troponin_2h_elevated and not prior_acs_or_nitrate and (palpation_reproduces_pain or (age < 40 and not pain_radiates_neck_jaw_arm)); age 40 is not the age-history path (Christenson 2006 derivation tree; not Cullen 2014 / Scheuermeyer 2014 age 50)",
      "age_years": 35,
      "troponin_2h_elevated": false,
      "criteria": [
        {
          "value": false,
          "factor": "normal_initial_ecg",
          "met": true
        },
        {
          "value": false,
          "factor": "troponin_2h_not_elevated",
          "met": true
        },
        {
          "value": false,
          "factor": "no_prior_acs_or_nitrate",
          "met": true
        },
        {
          "value": 35,
          "factor": "palpation_or_age_history",
          "met": true
        }
      ],
      "abnormal_initial_ecg": false,
      "early_discharge_eligible": true,
      "pain_radiates_neck_jaw_arm": false,
      "palpation_reproduces_pain": false,
      "prior_acs_or_nitrate": 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": "Christenson J, Innes G, McKnight D, et al.",
        "doi": "10.1016/j.annemergmed.2005.08.007",
        "id": "christenson-2006",
        "pmid": "16387209",
        "source": "Ann Emerg Med. 2006;47(1):1-10",
        "title": "A clinical prediction rule for early discharge of patients with chest pain"
      },
      "formula": "vancouver_chest_pain",
      "formula_expression": "early_discharge_eligible iff not abnormal_initial_ecg and not troponin_2h_elevated and not prior_acs_or_nitrate and (palpation_reproduces_pain or (age < 40 and not pain_radiates_neck_jaw_arm)); age 40 is not the age-history path (Christenson 2006 derivation tree; not Cullen 2014 / Scheuermeyer 2014 age 50)",
      "age_years": 35,
      "troponin_2h_elevated": false,
      "criteria": [
        {
          "value": false,
          "factor": "normal_initial_ecg",
          "met": true
        },
        {
          "value": false,
          "factor": "troponin_2h_not_elevated",
          "met": true
        },
        {
          "value": false,
          "factor": "no_prior_acs_or_nitrate",
          "met": true
        },
        {
          "value": 35,
          "factor": "palpation_or_age_history",
          "met": true
        }
      ],
      "abnormal_initial_ecg": false,
      "early_discharge_eligible": true,
      "pain_radiates_neck_jaw_arm": false,
      "palpation_reproduces_pain": false,
      "prior_acs_or_nitrate": false
    }
  ]
}

Response

Example JSON

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

{
  "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": "Christenson J, Innes G, McKnight D, et al.",
    "doi": "10.1016/j.annemergmed.2005.08.007",
    "id": "christenson-2006",
    "pmid": "16387209",
    "source": "Ann Emerg Med. 2006;47(1):1-10",
    "title": "A clinical prediction rule for early discharge of patients with chest pain"
  },
  "formula": "vancouver_chest_pain",
  "formula_expression": "early_discharge_eligible iff not abnormal_initial_ecg and not troponin_2h_elevated and not prior_acs_or_nitrate and (palpation_reproduces_pain or (age < 40 and not pain_radiates_neck_jaw_arm)); age 40 is not the age-history path (Christenson 2006 derivation tree; not Cullen 2014 / Scheuermeyer 2014 age 50)",
  "age_years": 35,
  "troponin_2h_elevated": false,
  "criteria": [
    {
      "value": false,
      "factor": "normal_initial_ecg",
      "met": true
    },
    {
      "value": false,
      "factor": "troponin_2h_not_elevated",
      "met": true
    },
    {
      "value": false,
      "factor": "no_prior_acs_or_nitrate",
      "met": true
    },
    {
      "value": 35,
      "factor": "palpation_or_age_history",
      "met": true
    }
  ],
  "abnormal_initial_ecg": false,
  "early_discharge_eligible": true,
  "pain_radiates_neck_jaw_arm": false,
  "palpation_reproduces_pain": false,
  "prior_acs_or_nitrate": false
}

Client errors (HTTP 400)

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

Related tools

• HEART score — Compute the HEART score as age points plus caller-assigned history, ECG, risk factors, and troponin (each 0-2).
• ADAPT — Apply the Than 2012 ADAPT 2-hour accelerated diagnostic protocol and return whether a caller-assigned TIMI UA/NSTEMI score plus initial ECG and 0-hour/2-hour troponin flags meet the published ADP-negative (low-risk) rule.
• 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.