Boston Criteria Diagnosis Congestive Heart Failure | Medical Algorithm

Does the patient have a history of?

• rest dyspnea?

Yes

• orthopnea?

Yes

• paroxysmal nocturnal dyspnea?

Yes

• dyspnea on walking on level?

Yes

• dyspnea on climbing?

Yes

Findings on physical examination:

Heart rate

beats per minute

Jugular venous pressure

cm water

Is hepatomegaly present?

Yes

Is edema present?

Yes

Are basilar lung crackles present?

Yes

Are lung crackles present above the basilar segments?

Yes

Is wheezing present?

Yes

Is a third heart sound present?

Yes

Does the chest X-ray show?

• alveolar pulmonary edema?

Yes

• interstitial pulmonary edema?

Yes

• bilateral pleural effusions?

Yes

• a cardiothoracic ratio > 0.50?

Yes

• upper zone flow redistribution?

Yes

Results

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Results Interpretation and Description References Next Steps

Data complete?

Points for history

Points for physical examination

Points for radiography

Score

Congestive heart failure is

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Risk Factors
Clinical Diagnosis, Including Family History For Genetics
Imaging Studies
Laboratory Tests
Other Testing
Criteria For Diagnosis
Severity, Prognosis, Stage
Complications
Differential Diagnosis And Mimics, Red Flags
- High-Output Heart Failure Associated with Arteriovenous Fistula, Hemangioma or Other Vascular Malformation
- Criteria for Distinguishing Acute Heart Failure from COPD or Asthma in Dyspneic Patient
Failure Handling, When To Refer
- Indications for Referral of Patient with Heart Failure to Cardiologist
- Recommended Triage Times for Patient with Heart Failure

Therapy

Options
- Treatment Outcome - B-Type Natriuretic Peptide - (BNP) and Severe Congestive Heart Failure (CHF)
Selection
Failure Handling And Therapy Escalation
Prevention
- Predicting Risk of Heart Failure in Framingham Study
- Two Minute Assessment of Hemodynamic Profile for Patient with Possible Heart Failure

Monitoring

Response To Therapy
Complication Detection
Comorbid Conditions

Patient Concerns

Disability And Performance
- Cognitive Dysfunction in Heart Failure
Quality Of Life
- Cognitive Dysfunction in Heart Failure
- Discharge Criteria for Patient Hospitalized for Heart Failure
End-of-life, Palliative Care
- Criteria for Inotrope Dependence | Refractory End-Stage Heart Failure
- Prognostic Factors for Ambulatory Patient w/ Chronic Congestive Heart Failure

Evaluation

Results

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Therapy

Monitoring

Patient Concerns

Specialty

Objective

ICD-10

Boston Criteria for Diagnosis Congestive Heart Failure

Purpose: To use a clinicoradiographic scoring system for the diagnosis of congestive heart failure.

Evaluation

Results

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Power Your Solutions with 5,000+ Automated Medical Analytics

Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Therapy

Monitoring

Patient Concerns

Specialty

Objective

ICD-10