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Criteria for Congestive Heart Failure, Framingham

Framingham Criteria for Congestive Heart Failure (CHF)#

Diagnosis of CHF requires the simultaneous presence of at least 2 major criteria or 1 major criterion in conjunction with 2 minor criteria.

Major criteria#

  • Paroxysmal nocturnal dyspnea
  • Neck vein distention
  • Rales
  • Radiographic cardiomegaly (increasing heart size on chest radiography)
  • Acute pulmonary edema
  • S3 gallop
  • Increased central venous pressure (>16 cm H₂O at right atrium)
  • Hepatojugular reflux
  • Weight loss >4.5 kg in 5 days in response to treatment

Minor criteria#

  • Bilateral ankle edema
  • Nocturnal cough
  • Dyspnea on ordinary exertion
  • Hepatomegaly
  • Pleural effusion
  • Decrease in vital capacity by one third from maximum recorded
  • Tachycardia (heart rate>120 beats/min.)

Minor criteria are acceptable only if they cannot be attributed to another medical condition (such as pulmonary hypertension, chronic lung disease, cirrhosis, ascites, or the nephrotic syndrome).

The Framingham Heart Study diagnostic criteria are 97% sensitive and 79% specific for diagnosis of persons with definite congestive heart failure.


Related Pages#

References/Websites#