Table 2

Boston index for evaluating signs and symptoms of heart failure (SSHF)

Category Point
I: History from questionnaire or case record
 Rest dyspnoea, orthopnoea4
 Paroxysmal nocturnal dyspnoea3
 Dyspnoea on walking on level2
 Dyspnoea on climbing1
II: Physical examination from case record
 If heart rate > 91 to 110 beats/min1
 If heart rate >110 beats/min2
 Neck vein distension, hepatomegaly or leg oedema2
 Lung crackles2
 Third heart sound3
III: Chest radiography from case record
 Alveolar pulmonary oedema4
 Interstitial pulmonary oedema3
 Bilateral pleural effusions3
 Cardiothoracic ratio > 0.492
 Upper zone flow redistribution1
  • Patients with suspected or definite heart disease were evaluated by this index if they had been treated or referred for heart failure. The sum within each category contributed at most four points to the composite score. SSHF was a composite score of ⩾ 5 points.