NYHA Classification

Functional Classification Systems

  • The New York Heart Association (NYHA) functional classification is based on the amount of activity needed to elicit symptoms from the patient.
  • The American College of Cardiology/American Heart Association (ACC/AHA) classification describes the progressive stages in the development of heart failure.
  • Signs and symptoms associated with heart failure include fatigue, exertional and resting dyspnea, orthopnea, peripheral edema, and increased jugulovenous distention (JVD), among others.
  • Examples of conditions that cause low output heart failure include coronary artery disease, hypertension, cardiomyopathy, pericardial disease, arrhythmias, and valvular disease.
  • Examples of conditions that cause high output heart failure include severe anemia, thyrotoxicosis, Paget’s disease of bone, sepsis, systemic arteriovenous shunts, and beriberi.

NYHA Functional Classification of Heart Failure

NYHA ClassDescription
INo limitation of physical activity; ordinary physical activity does not cause symptoms
IISlight limitation of physical activity; comfortable at rest; ordinary physical activity causes symptoms
IIIMarked limitation of physical activity; comfortable at rest, but less than ordinary activity causes symptoms
IV Severe limitation and discomfort with any physical activity; symptoms present even at rest

ACC/AHA Stages of Heart Failure

AAt high risk for the development of heart failure, but without any structural heart disease, functional heart abnormality, or symptoms of heart failure
BStructural heart disease, but without signs or symptoms of heart failure
CStructural heart disease with past or current symptoms of heart failure
DAdvanced heart disease with refractory heart failure requiring specialized interventions

Match the description to the corresponding classification