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Framingham heart failure criteria

Classic Framingham study clinical criteria for bedside diagnosis of congestive heart failure.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

Framingham/McKee 1971: 2 major or 1 major+2 minor; weight loss counted as major

The major and minor criteria must be present simultaneously; alternative causes of the signs must be considered. This interface treats a loss of at least 4.5 kg in 5 days during treatment as a major criterion; do not assign this scoring weight to weight loss outside that context. The historical set does not establish every current heart-failure phenotype or replace structural and functional assessment. The 2006 Framingham protocol contains additional items and must not be presented as though each of them were implemented in this historical version.

Required fields: 0/17 completed

Complete all required fields. Optional fields are marked.

Major: paroxysmal nocturnal dyspnea or orthopnea required

Major: jugular venous distension required

Major: pulmonary crackles required

Major: cardiomegaly on chest radiograph required

Major: acute pulmonary edema required

Major: third heart sound (gallop) required

Major: central venous pressure > 16 cmH₂O required

Major: circulation time ≥ 25 s required

Major: hepatojugular reflux required

Major or minor: weight loss ≥ 4.5 kg in 5 days with treatment required

Minor: bilateral ankle edema required

Minor: nocturnal cough required

Minor: dyspnea on ordinary exertion required

Minor: hepatomegaly required

Minor: pleural effusion required

Minor: vital capacity reduced by 1/3 of maximum required

Minor: tachycardia (heart rate ≥ 120 bpm) required

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Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Major: paroxysmal nocturnal dyspnea or orthopnea
Major: jugular venous distension
Major: pulmonary crackles
Major: cardiomegaly on chest radiograph
Major: acute pulmonary edema
Major: third heart sound (gallop)
Major: central venous pressure > 16 cmH₂O
Major: circulation time ≥ 25 s
Major: hepatojugular reflux
Major or minor: weight loss ≥ 4.5 kg in 5 days with treatment
Minor: bilateral ankle edema
Minor: nocturnal cough
Minor: dyspnea on ordinary exertion
Minor: hepatomegaly
Minor: pleural effusion
Minor: vital capacity reduced by 1/3 of maximum
Minor: tachycardia (heart rate ≥ 120 bpm)

4/4 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Heart failure diagnosis with 2 major criteria or 1 major + 2 minor.

Minor criteria count only if not attributable to another condition (e.g. pulmonary hypertension, COPD, cirrhosis, ascites or nephrotic syndrome). Weight loss with treatment may count as major or minor; here it counts as major.

References

Identifier: criterios-de-framingham-ic

Original clinical content: Brazilian Portuguese.

Method version

Framingham/McKee 1971: 2 major or 1 major+2 minor; weight loss counted as major

criterios-de-framingham-ic@native-2026-10-03+65231824a87e

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (4)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Major: paroxysmal nocturnal dyspnea or orthopnea: No
Major: jugular venous distension: No
Major: pulmonary crackles: No
Major: cardiomegaly on chest radiograph: No
Major: acute pulmonary edema: No
Major: third heart sound (gallop): No
Major: central venous pressure > 16 cmH₂O: No
Major: circulation time ≥ 25 s: No
Major: hepatojugular reflux: No
Major or minor: weight loss ≥ 4.5 kg in 5 days with treatment: No
Minor: bilateral ankle edema: No
Minor: nocturnal cough: No
Minor: dyspnea on ordinary exertion: No
Minor: hepatomegaly: No
Minor: pleural effusion: No
Minor: vital capacity reduced by 1/3 of maximum: No
Minor: tachycardia (heart rate ≥ 120 bpm): No

{
  "dpn": false,
  "turgencia": false,
  "estertores": false,
  "cardiomegalia": false,
  "eap": false,
  "b3": false,
  "pvc": false,
  "tc": false,
  "refluxo": false,
  "perda": false,
  "edema": false,
  "tosse": false,
  "dispneia": false,
  "hepatomegalia": false,
  "derrame": false,
  "cv": false,
  "taqui": false
}

Expected result

{
  "maiores": 0,
  "menores": 0,
  "dx": false
}

Actual result

{
  "maiores": 0,
  "menores": 0,
  "dx": false
}

Case 2

reference-002

Inputs

Major: paroxysmal nocturnal dyspnea or orthopnea: Yes
Major: pulmonary crackles: Yes
Major: jugular venous distension: No
Major: cardiomegaly on chest radiograph: No
Major: acute pulmonary edema: No
Major: third heart sound (gallop): No
Major: central venous pressure > 16 cmH₂O: No
Major: circulation time ≥ 25 s: No
Major: hepatojugular reflux: No
Major or minor: weight loss ≥ 4.5 kg in 5 days with treatment: No
Minor: bilateral ankle edema: No
Minor: nocturnal cough: No
Minor: dyspnea on ordinary exertion: No
Minor: hepatomegaly: No
Minor: pleural effusion: No
Minor: vital capacity reduced by 1/3 of maximum: No
Minor: tachycardia (heart rate ≥ 120 bpm): No

{
  "dpn": true,
  "estertores": true,
  "turgencia": false,
  "cardiomegalia": false,
  "eap": false,
  "b3": false,
  "pvc": false,
  "tc": false,
  "refluxo": false,
  "perda": false,
  "edema": false,
  "tosse": false,
  "dispneia": false,
  "hepatomegalia": false,
  "derrame": false,
  "cv": false,
  "taqui": false
}

Expected result

{
  "maiores": 2,
  "dx": true
}

Actual result

{
  "maiores": 2,
  "menores": 0,
  "dx": true
}

Case 3

reference-003

Inputs

Major: third heart sound (gallop): Yes
Minor: bilateral ankle edema: Yes
Minor: nocturnal cough: Yes
Major: paroxysmal nocturnal dyspnea or orthopnea: No
Major: jugular venous distension: No
Major: pulmonary crackles: No
Major: cardiomegaly on chest radiograph: No
Major: acute pulmonary edema: No
Major: central venous pressure > 16 cmH₂O: No
Major: circulation time ≥ 25 s: No
Major: hepatojugular reflux: No
Major or minor: weight loss ≥ 4.5 kg in 5 days with treatment: No
Minor: dyspnea on ordinary exertion: No
Minor: hepatomegaly: No
Minor: pleural effusion: No
Minor: vital capacity reduced by 1/3 of maximum: No
Minor: tachycardia (heart rate ≥ 120 bpm): No

{
  "b3": true,
  "edema": true,
  "tosse": true,
  "dpn": false,
  "turgencia": false,
  "estertores": false,
  "cardiomegalia": false,
  "eap": false,
  "pvc": false,
  "tc": false,
  "refluxo": false,
  "perda": false,
  "dispneia": false,
  "hepatomegalia": false,
  "derrame": false,
  "cv": false,
  "taqui": false
}

Expected result

{
  "maiores": 1,
  "menores": 2,
  "dx": true
}

Actual result

{
  "maiores": 1,
  "menores": 2,
  "dx": true
}

Case 4

reference-004

Inputs

Major: jugular venous distension: Yes
Minor: bilateral ankle edema: Yes
Major: paroxysmal nocturnal dyspnea or orthopnea: No
Major: pulmonary crackles: No
Major: cardiomegaly on chest radiograph: No
Major: acute pulmonary edema: No
Major: third heart sound (gallop): No
Major: central venous pressure > 16 cmH₂O: No
Major: circulation time ≥ 25 s: No
Major: hepatojugular reflux: No
Major or minor: weight loss ≥ 4.5 kg in 5 days with treatment: No
Minor: nocturnal cough: No
Minor: dyspnea on ordinary exertion: No
Minor: hepatomegaly: No
Minor: pleural effusion: No
Minor: vital capacity reduced by 1/3 of maximum: No
Minor: tachycardia (heart rate ≥ 120 bpm): No

{
  "turgencia": true,
  "edema": true,
  "dpn": false,
  "estertores": false,
  "cardiomegalia": false,
  "eap": false,
  "b3": false,
  "pvc": false,
  "tc": false,
  "refluxo": false,
  "perda": false,
  "tosse": false,
  "dispneia": false,
  "hepatomegalia": false,
  "derrame": false,
  "cv": false,
  "taqui": false
}

Expected result

{
  "maiores": 1,
  "menores": 1,
  "dx": false
}

Actual result

{
  "maiores": 1,
  "menores": 1,
  "dx": false
}

Code and reproducibility

This tool’s code on GitHub

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Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.