New York Heart Association Format For Cardiac Diagnosis

ETIOLOGY

ANATOMY

PHYSIOLOGY

FUNCTIONAL CAPACITY

OBJECTIVE ASSESSMENT

Common examples under each category:

• Etiology: Atherosclerosis (ASHD), Hypertension (HHD), Acute Rheumatic Fever (RHD), Pulmonary disease (Cor Pulmonale), Amyloid, Carcinoid, etc. If the etiology is uncertain, the designation is heart disease of unknown etiology.
• Anatomy: Anatomical derangements of the aorta, pulmonary arteries, coronary arteries, valves, endocardium, myocardium, and pericardium, e.g. aortic aneurysm, aortitis, coronary atherosclerosis, mitral stenosis, coronary thrombosis, endocarditis, fibroelastosls, pericarditis, myocarditis, acute myocardial infarction, ventricular aneurysm, pericardial effusion, VSD, ETC.
• Physiology; NSR, PAT~ VPS's. LBBB, Complete Heart Block, CHF, Pulmonary Hypertension, Angina, Stokes-Adams Syndrome, WPW Syndrome, Cardiogenic Shock
• Functional Capacity:
• Class I. Patients with cardiac disease, but without resulting limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea, or anginal pain
• Class II. Patients with cardiac disease resulting in slight Limitation of physical activity. They are comfortable at rest, ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain.
• Class III. Patients with marked limitation of physical activity. They are comfortable at rest. Less than ordinary activity causes fatigue, palpitation, dyspnea, or anginal pain.
• Class IV. Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of heart failure or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.
• Objective Assessment:
• A. No objective evidence of cardiovascular disease.
• B. Objective evidence of minimal cardiovascular disease.
• C. Objective evidence of moderately severe cardiovascular disease.
• D. Objective evidence of severe cardiovascular disease.

For example, in a patient in the second week after a large, complicated myocardial infarction:

ETIOLOGY: Atherosclerotic heart disease

ANATOMY: Coronary atherosclerosis and thrombosis

Acute anterior wall myocardial infarction

Enlarged heart and probable ventricular aneurysm

PHYSIOLOGY: NSR with occasional VPB's

Congestive heart failure and cardiogenic shock

FUNCTIONAL CAPACITY: IV

OBJECTIVE ASSESSMENT: D