PLE-1921

PLE-1921

A 75-year-old male went to you complaining of bipedal edema, paroxysmal nocturnal dyspnea, and exertional dyspnea. Physical exam showed grade 2 bipedal edema, tachycardia, and hepatomegaly. Based on the Framingham criteria, which salient feature is a major criterion for the diagnosis of heart failure?