MCQ 38

Q. Which of the following is not a major criteria for congestive heart failure?
A. Hepatojugular reflex
B. PND attacks
C. S3 gallop
D. Tachycardia (Heart rate more than 120/minute)

Answer: D. Tachycardia (Heart rate more than 120/minute)

Explanation: 
Framingham proposed the diagnostic criteria for congestive heart failure.
Either 2 major or one major and 2 minor criterias should be fulfilled for the diagnosis of CHF

Major criterias are:

1. Paroxysmal nocturnal dyspnea
2. Weight loss of 4.5 kg in 5 days in response to treatment
3. Neck vein distention
4. Rales
5. Acute pulmonary edema
6. Hepatojugular reflux
7. S ₃ gallop
8. Central venous pressure >16 cm water
9. Circulation time of ≥25 seconds
10. Radiographic cardiomegaly
11. Pulmonary edema, visceral congestion, or cardiomegaly at autopsy

And minor criterias are:

1. Nocturnal cough
2. Dyspnea on ordinary exertion
3. A decrease in vital capacity by one third the maximal value recorded
4. Pleural effusion
5. Tachycardia (rate of 120 bpm)
6. Hepatomegaly
7. Bilateral ankle edema