Steinhart Model for Acute Heart Failure (AHF) in Undifferentiated Dyspnea
Steinhart Model for AHF
NT-proBNP ≥1500 pg/mL
Prior History of Heart Failure
Orthopnea
S3 Gallop
Rales on Auscultation
Jugular Venous Distension (JVD)
Peripheral Edema
Score:–
–
–
Diagnoses acute heart failure with NT-proBNP in undifferentiated dyspneic patients.
Formula
Probability of clinical AHF diagnosis = 1 / (1 + e y ) Where y = 8 + 0.011 x age – 5.9 × pre-test probability – 2.3 × log 10 (NT-proBNP) + 0.82 × pre-test probability × log 10 (NT-proBNP) Note: pre-test probability is in %; NT-proBNP is in pg/mL (pmol/L).
Pearls / Pitfalls
Uses NT-proBNP specifically, not standard BNP, which may not be available in all settings. Best applied in situations where the diagnosis is equivocal (i.e., when pre-test probability is neither very low nor very high).
Advice
Investigate other causes of dyspnea in cases where acute heart failure is ruled out.