Framingham Heart Failure Diagnostic Criteria
Framingham HF Criteria Calculator
Major Criteria
PND or Orthopnea
Neck Vein Distension
Rales
Cardiomegaly on CXR
Acute Pulmonary Edema
S3 Gallop
Hepatojugular Reflux
Weight Loss >4.5 kg in 5 Days with Treatment
Minor Criteria
Bilateral Ankle Edema
Night Cough
Dyspnea on Exertion
Hepatomegaly
Pleural Effusion
Tachycardia (HR >120 bpm)
Major / Minor:
0
Diagnoses heart failure based on major and minor criteria.
Why Use
Heart failure is a clinical diagnosis. The Framingham HF Diagnostic Criteria offer an acceptable set of criteria to make the diagnosis. Other diagnostic criteria include the New York Heart Association (NYHA) Classification.
When to Use
Patients with signs and symptoms of heart failure (HF).
Formula
Diagnosis of HF requires 2 major criteria OR 1 major and 2 minor criteria: Major criteria Acute pulmonary edema. Cardiomegaly. Hepatojugular reflux. Neck vein distention. Paroxysmal nocturnal dyspnea or orthopnea. Pulmonary rales. Third heart sound (S3 gallop rhythm). Weight loss >4.5 kg in 5 days in response to treatment. Minor criteria Ankle edema. Dyspnea on exertion. Hepatomegaly. Nocturnal cough. Pleural effusion. Tachycardia (HR >120)
Pearls / Pitfalls
Minor criteria should only be selected if they cannot be explained by another comorbidity, e.g. dyspnea on exertion secondary to chronic obstructive pulmonary disease.
Advice
Treat patient for heart failure. Consider referral to a cardiologist.