As a result, coronary catheterization may be used to identify possibilities for revascularisation through percutaneous coronary intervention or bypass surgery. Algorithms
Various algorithms are used for the diagnosis of heart failure. For example, the algorithm used by the Framingham Heart Study adds together criteria mainly from physical examination. In contrast, the more extensive algorithm by the European Society of Cardiology  weights the difference between supporting and opposing parameters from the medical history, physical examination, further medical tests, and response to therapy. Framingham criteria
By the Framingham criteria, diagnosis of congestive heart failure (heart failure with impaired pumping capability) requires the simultaneous presence of at least two of the following major criteria or one major criterion in conjunction with two of the minor criteria. Major criteria includean enlarged heart on a chest X-ray,
an S3 gallop (a third heart sound),
acute pulmonary edema,
episodes of waking up from sleep gasping for air, crackles on lung auscultation,
central venous pressure more than 16 cm H2O at the right atrium,
jugular vein distension,
positive abdominojugular test, and
weight loss more than 4.5 kg in 5 days in response to treatment (sometimes classified as a minor criterion).Minor criteria includean abnormally fast heart rate more than 120 beats per minute,
nocturnal cough,
difficulty breathing with physical activity,
pleural effusion,
a decrease in the vital capacity by one-third from maximum recorded,
liver enlargement, and
bilateral ankle edema.Minor criteria are acceptable only if they can not be attributed to another medical condition such as pulmonary hypertension, chronic lung disease, cirrhosis, ascites, or the nephrotic syndrome.
Although some people survive many years, progressive disease is associated with an overall annual mortality rate of 10%.Around 18 of every 1000 persons will experience an ischemic stroke during the first year after diagnosis of HF. As the duration of follow-up increases, the stroke rate rises to nearly 50 strokes per 1000 cases of HF by 5 years. Epidemiology
In 2022, heart failure affected about 64 million people globally. Overall, around 2% of adults have heart failure and in those over the age of 65, this increases to 6–10%. Above 75 years old, rates are greater than 10%.Rates are predicted to increase. Increasing rates are mostly because of increasing lifespan, but also because of increased risk factors (hypertension, diabetes, dyslipidemia, and obesity) and improved survival rates from other types of cardiovascular disease (myocardial infarction, valvular disease, and arrhythmias). Heart failure is the leading cause of hospitalization in people older than 65. United States
In the United States, heart failure affects 5.8 million people, and each year 550,000 new cases are diagnosed. In 2011, heart failure was the most common reason for hospitalization for adults aged 85 years and older, and the second-most common for adults aged 65–84 years. An estimated one in five adults at age 40 will develop heart failure during their remaining lifetimes and about half of people who develop heart failure die within 5 years of diagnosis. Heart failure is much higher in African Americans, Hispanics, Native Americans, and recent immigrants from the Eastern Bloc countries such as Russia.