Reithmann et al reported a score for infants and children with congestive heart failure. This is based on the modified Ross Score of Laer et al. The authors are from the University of Munich and University Halle-Wittenberg.
Patient selection: pediatric patient with heart failure
Parameters from the score of Laer et al:
(1) diaphoresis
(2) tachypnea
(3) breathing
(4) respiratory rate for age in breaths per minute
(5) heart rate for age in beats per minute
(6) hepatomegaly (distance of the liver edge below the right costal margin in cm)
|
Parameter |
Finding |
Points |
|
diaphoresis |
head only |
0 |
|
|
head and body on exertion |
1 |
|
|
head and body at rest |
2 |
|
tachypnea |
rare |
0 |
|
|
several times |
1 |
|
|
frequent |
2 |
|
breathing |
normal |
0 |
|
|
retractions |
1 |
|
|
dyspnea |
2 |
|
liver edge |
< 2 cm below costal margin |
0 |
|
|
2 to 3 cm below costal margin |
1 |
|
|
> 3 cm below costal margin |
2 |
|
Age |
Respiratory Rate |
Points |
|
0 to 1 |
< 50 |
0 |
|
|
50 to 60 |
1 |
|
|
> 60 |
2 |
|
1 to 6 |
< 35 |
0 |
|
|
35 to 45 |
1 |
|
|
> 45 |
2 |
|
7 to 10 |
< 25 |
0 |
|
|
25 to 35 |
1 |
|
|
> 35 |
2 |
|
11 to 14 |
< 18 |
0 |
|
|
18 to 28 |
1 |
|
|
> 28 |
2 |
|
Age |
Heart Rate |
Points |
|
0 to 1 |
< 160 |
0 |
|
|
160 to 170 |
1 |
|
|
> 170 |
2 |
|
1 to 6 |
< 105 |
0 |
|
|
105 to 115 |
1 |
|
|
> 115 |
2 |
|
7 to 10 |
< 90 |
0 |
|
|
90 to 100 |
1 |
|
|
> 100 |
2 |
|
11 to 14 |
< 80 |
0 |
|
|
80 to 90 |
1 |
|
|
> 90 |
2 |
Additional Parameters:
(7) episodes of hypoxemia
(8) weight percentile
(9) skin perfusion
(10) cyanosis
(11) precordial thrill
|
Parameter |
Finding |
Points |
|
episodes of hypoxemia |
absent |
0 |
|
|
present |
2 |
|
weight percentile |
> 10%ile |
0 |
|
|
3 to 10%ile |
1 |
|
|
< 3%ile |
2 |
|
skin perfusion |
normal |
0 |
|
|
decreased (marbling) |
1 |
|
|
markedly decreased |
2 |
|
cyanosis |
absent |
0 |
|
|
peripheral |
1 |
|
|
present |
2 |
|
precordial thrill |
absent |
0 |
|
|
present |
1 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• The higher the score the more severe the heart failure.
• A score > 6 is seen with moderate or severe heart failure.
Specialty: Cardiology
