Heart Failure Classifications
Heart failure symptoms are usually graded based on a special classification system developed by the New York Heart Association classification (NYHA Class I, II, III, or IV). The classifications in this chart are based on symptoms experienced during physical activity. In general, Class I patients have asymptomatic heart failure, meaning they do not show symptoms; Class II mild heart failure; Class III moderate to severe heart failure, and; Class IV severe heart failure.
Classifying Heart Failure Grid
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| Class I • Mild | Class II • Mild | Class III • Moderate | Class IV • Severe | |
| Symptoms | No symptoms Can perform ordinary activities without any limitations |
Mild symptoms - occasional swelling Somewhat limited in ability to exercise or do other strenuous activities |
Noticeable limitations in ability to exercise or participate in mildly strenuous activities Comfortable only at rest |
Unable to do any physical activity without discomfort Some HF symptoms at rest |
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| Treatments | Drugs Lifestyle adjustments Family education |
Drugs Lifestyle adjustments Family education Device therapy for those with an EF < 40%. (An EF** less than 40% is associated with an increased risk of sudden cardiac death.) |
Drugs Lifestyle adjustments Family education Device Therapy: heart failure pacemaker with or without a defibrillator Surgery |
Drugs Lifestyle adjustments Family education Device Therapy: heart failure pacemaker with or without a defibrillator Surgery Special interventions: heart transplant |
| Heart Failure Medical Care | Internist/General Practitioner |
Internist/General Practitioner Cardiologist (Heart Specialist/ Heart Failure Specialist) |
Multidisciplinary team: |
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| Actions You Can Take | Ask your doctor if you are at risk for heart failure. If you have heart failure, develop a treatment plan with your doctor. If you have had a heart attack, know your “EF.” (Ejection Fraction: your heart’s pumping ability and a key indicator of heart health.) |
Talk with your doctor about your symptoms. Ask your doctor about heart failure drugs such as ACE inhibitors and beta blockers. Know your “EF.” Find a doctor who specializes in heart failure. Talk to your doctor to see if an implantable defibrillator is right for you. |
Have a Heart Failure Specialist follow your care. Talk with your doctor about your symptoms. Ask your doctor about heart failure drugs such as ACE inhibitors, beta blockers, and diuretics. Know your “EF.”** Ask your Heart Failure Specialist about your need to see a Heart Rhythm Specialist. Ask your doctor if a heart failure pacemaker with or without a defibrillator is right for you. |
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* Based on the New York Heart Association (NYHA) functional classification system. |
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