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 can not be attributed to another medical condition (such as
pulmonary hypertension, chronic lung disease, cirrhosis, ascites, or the nephrotic syndrome).
The Framingham Heart Study
criteria are 100% sensitive and 78% specific for identifying persons
with definite congestive heart failure.
Reference:
-
McKee PA, Castelli WP, McNamara PM, Kannel WB. The natural history of congestive heart failure: the Framingham study. N Engl J Med. 1971 Dec 23;285(26):1441-6. [Medline]
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