Framingham heart failure diagnostic criteria

It’s used to diagnose heart failure (HF) based on a combination of major and minor criteria.


Major criteria- 

1. Paroxysmal nocturnal dyspnea

2. Neck vein distention

3. Pulmonary rales (crackles in the lungs)

4. Radiographic cardiomegaly (heart enlargement on X-ray)

5. Acute pulmonary edema

6. S3 gallop (third heart sound)

7. Hepatojugular reflux

8. Weight loss >4.5 kg in 5 days in response to treatment


Minor criteria-

1. Bilateral ankle edema

2. Nocturnal cough

3. Dyspnea on ordinary exertion

4. Hepatomegaly (enlarged liver)

5. Pleural effusion 

6. Tachycardia (heart rate >120 beats per minute)


For a diagnosis of heart failure, at least 

1. Two major criteria 

2. One major criterion + Two minor criteria 

must be present.

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