Possible total of 14:
Age >75 years - score 1
Orthopnea present - score 2
Lack of cough - score 1
Current use of a loop diuretic (before presentation) - score 1
Rales - score 1
Lack of fever - score 2
Elevated N-terminal pro-brain natriuretic peptide (NT-proBNP)* - score 4
Interstitial edema on CXR - score 2.
Likelihood of heart failure:
Low: 0 to 5
Intermediate: 6 to 8
High: 9 to 14.
* Elevated NT-proBNP defined as >450 pg/mL if age <50 years and >900 pg/mL if age >50 years.
The Framingham criteria are the most widely accepted clinical criteria for diagnosing heart failure. For establishing a definite diagnosis of CHF, 2 major criteria or 1 major and 2 minor criteria must be present.
Major criteria are:
Paroxysmal nocturnal dyspnea or orthopnea
Acute pulmonary edema
Increased venous pressure >16 cm of water
Circulation time 25 seconds or longer
Minor criteria are:
Dyspnea on exertion
Vital capacity reduced one third from maximum
Tachycardia (≥120 bpm).
Major or minor criteria are:
Weight loss of 4.5 kg or more in 5 days in response to treatment.
Class I: asymptomatic
Class II: mild symptoms with moderate exertion
Class III: symptoms with minimal activity
Class IV: symptoms at rest.