Criterion

Point value

Category I: history

Rest dyspnea

4

Orthopnea

4

Paroxysmal nocturnal dyspnea

3

Dyspnea while walking on level area

2

Dyspnea while climbing

1

Category II: physical examination

Heart rate abnormality (1 point if 91 to 110 beats per minute; 2 points if more than 110 beats per minute)

1 or 2

Jugular venous elevation (2 points if greater than 6 cm H₂O; 3 points if greater than 6 cm H₂O plus hepatomegaly or edema)

2 or 3

Lung crackles (1 point if basilar; 2 points if more than basilar)

1 or 2

Wheezing

3

Third heart sound

3

Category III: chest radiography

Alveolar pulmonary edema

4

Interstitial pulmonary edema

3

Bilateral pleural effusion

3

Cardiothoracic ratio greater than 0.50

3

Upper zone flow redistribution

2