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Heart failure - chronic - Background information
What is the New York Heart Association classification of severity of heart failure symptoms?

  • The New York Heart Association (NYHA) classification grades the severity of heart failure symptoms as one of four functional classes. The NYHA classification is widely used in clinical practice and in research because it provides a standard description of severity that can be used to assess response to treatment and to guide management. It is less useful for prognosis because symptoms can fluctuate and the severity of symptoms does not always reflect the severity of the underlying heart problem — people with severe heart disease can have mild symptoms, and vice versa.
  • NYHA classification of heart failure symptoms [American Heart Association, 1994]:
    • Class I: asymptomatic left ventricular dysfunction is included in this category:
      • No limitations. Ordinary physical activity does not cause fatigue, breathlessness, or palpitation.
    • Class II: symptomatically 'mild' heart failure:
      • Slight limitation of physical activity. Such people are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, breathlessness, or angina pectoris.
    • Class III: symptomatically 'moderate' heart failure:
      • Marked limitation of physical activity. Although people are comfortable at rest, less than ordinary physical activity will lead to symptoms.
    • Class IV: symptomatically 'severe' heart failure:
      • Inability to carry on any physical activity without discomfort. Symptoms of cardiac failure are present even at rest.

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