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
|I||No limitation of physical activity; ordinary physical activity does not cause symptoms|
|II||Slight limitation of physical activity; comfortable at rest; ordinary physical activity causes symptoms|
|III||Marked 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
|A||At high risk for the development of heart failure, but without any structural heart disease, functional heart abnormality, or symptoms of heart failure|
|B||Structural heart disease, but without signs or symptoms of heart failure|
|C||Structural heart disease with past or current symptoms of heart failure|
|D||Advanced heart disease with refractory heart failure requiring specialized interventions|