{"id":79,"date":"2009-02-27T18:36:41","date_gmt":"2009-02-27T18:36:41","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/carboston\/"},"modified":"2025-05-14T20:58:31","modified_gmt":"2025-05-14T20:58:31","slug":"carboston","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/carboston\/","title":{"rendered":"Boston Criteria for Diagnosing Heart Failure"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>The Boston criteria uses the information from history, physical examination, and chest radiography to categorize the diagnosis of heart failure.<br \/>\n<!--more--><\/p>\n<table style=\"border-collapse: collapse; width: 100%; height: 506px;\" border=\"1\">\n<tbody>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\"><strong>Criterion<\/strong><\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\"><strong>Point value<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\" colspan=\"2\"><em>Category I: history<\/em><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Rest dyspnea<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">4<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Orthopnea<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">4<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Paroxysmal nocturnal dyspnea<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Dyspnea while walking on level area<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">2<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Dyspnea while climbing<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">1<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\" colspan=\"2\"><em>Category II: physical examination<\/em><\/td>\n<\/tr>\n<tr style=\"height: 48px;\">\n<td style=\"width: 82.5343%; height: 48px;\">Heart rate abnormality (1 point if 91 to 110 beats per minute; 2 points if more than 110 beats per minute)<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 48px;\">1 o 2<\/td>\n<\/tr>\n<tr style=\"height: 50px;\">\n<td style=\"width: 82.5343%; height: 50px;\">Jugular venous elevation (2 points if greater than 6 cm H<sub>2<\/sub>O; 3 points if greater than 6 cm H<sub>2<\/sub>O plus hepatomegaly or edema)<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 50px;\">2 o 3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Lung crackles (1 point if basilar; 2 points if more than basilar)<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">1 o 2<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Wheezing<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Third heart sound<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\" colspan=\"2\"><em>Category III: chest radiography<\/em><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Alveolar pulmonary edema<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">4<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Interstitial pulmonary edema<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Bilateral pleural effusion<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Cardiothoracic ratio greater than 0.50<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 82.5343%; height: 24px;\">Upper zone flow redistribution<\/td>\n<td style=\"width: 17.4657%; text-align: center; height: 24px;\">2<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\">No more than 4 points are allowed from each of three categories; hence the composite score (the sum of the subtotal from each category) has a possible maximum of 12 points. The diagnosis of heart failure is classified as &#8220;definite&#8221; at a score of 8 to 12 points, &#8220;possible&#8221; at a score of 5 to 7 points, and &#8220;unlikely&#8221; at a score of 4 points or less.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol>\n<li>Marantz PR, Tobin JN, Wassertheil-Smoller S, Steingart RM, Wexler JP, Budner N, Lense L, Wachspress J. The relationship between left ventricular systolic function and congestive heart failure diagnosed by clinical criteria. Circulation. 1988 Mar;77(3):607-12.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/3342491\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Remes J, Miettinen H, Reunanen A, Pyorala K. Validity of clinical diagnosis of heart failure in primary health care. Eur Heart J. 1991 Mar;12(3):315-21.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/2040313\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>Created: Jul 17, 2006<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[26],"tags":[1752,1183,1348,16,15,1136,674,901,673],"class_list":["post-79","post","type-post","status-publish","format-standard","hentry","category-cardiology","tag-boston","tag-cardiaco","tag-cardiology","tag-criteria","tag-criterios","tag-diagnosing","tag-failure","tag-fallo","tag-heart"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/79","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=79"}],"version-history":[{"count":7,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/79\/revisions"}],"predecessor-version":[{"id":9384,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/79\/revisions\/9384"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=79"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=79"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=79"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}