Framingham Heart Failure Diagnostic Criteria

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Clinical Use

Assist diagnosis of heart failure

More Info

The Framingham Heart Failure Diagnostic Criteria derived from The Framingham Study conducted in 5192 persons over a 16-year period.

Diagnosis of heart failure requires 2 major criteria OR 1 major and 2 minor criteria:
Major criteria
Acute pulmonary edema.
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.
Nocturnal cough.
Pleural effusion.
Tachycardia (HR >120)


Test Sensitivity: 97%    Test Specificity: 79%

Related Tools


1. 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. Abstract


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Developer: Sirikarn Napan, MD, FACC