Classes and Stages of Heart Failure
Two systems are currently used to describe heart failure.
The New York Heart Association (NYHA) functional classification
Class I (Mild). No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, or shortness of breath.
Class II (Mild). Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue, palpitation, or shortness of breath.
Class III (Moderate). Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes fatigue, palpitation, or dyspnea.
Class IV (Severe). Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency at rest. If any physical activity is undertaken, discomfort is increased.
The American College of Cardiology and the American Heart Association staging system
Stage A. Patients at risk for heart failure, with no evidence of the syndrome and no symptoms.
Stage B. Patients with structural heart disease, such as a prior myocardial infarction (MI) or asymptomatic left ventricular systolic dysfunction, but have not been identified as having heart failure.
Stage C. Patients with structural heart disease who previously or currently have symptoms of heart failure.
Stage D. Patients with continued symptoms of heart failure symptoms on optimal medical therapy.
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