Answer 3 Orthopnea. According to the Framingham criteria for congestive heart failure, orthopnea is considered a major criterion for heart failure. Patients with heart failure require increased numbers of pillows to sleep at night in order to avoid symptoms of orthopnea. The number of pillows used can help gauge the severity of heart failure. Paroxysmal nocturnal dyspnea, another major criterion, refers to attacks of shortness of breath that occur at night and may awaken the patient from sleeping. Dyspnea on exertion, a nocturnal cough, and ankle edema are considered minor criteria. Click here to return to the questions
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