Modified Framingham clinical criteria for the diagnosis of heart failure

Major

Paroxysmal nocturnal dyspnea

Orthopnea

Elevated jugular venous pressure

Pulmonary rales

3^rd heart sound

Cardiomegaly on chest radiograph

Pulmonary edema on chest radiograph

Weight loss ≥4.5 kg in 5 days in response to treatment of presumed heart failure*

Minor

Bilateral leg edema

Nocturnal cough

Dyspnea on ordinary exertion

Hepatomegaly

Pleural effusion

Tachycardia (heart rate ≥120 beats/min)

Weight loss ≥4.5 kg in 5 days*

Diagnosis

The diagnosis of heart failure requires that 2 major or 1 major and 2 minor criteria cannot be attributed to another medical condition.

* If weight loss is clearly related to heart failure treatment, it represents a major criterion. If the cause for weight loss is unclear, it represents a minor criterion.

Adapted from: McKee PA, Castelli WP, McNamara PM, Kannel WB. The natural history of congestive heart failure: the Framingham study. N Engl J Med 1971; 285:1441.

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Modified Framingham clinical criteria for the diagnosis of heart failure