Classification and Staging of

Heart Failure

New York Heart Association (NYHA) Functional Classification:
  • Class I: No limitations; ordinary physical activity does not cause symptoms.
  • Class II: Slight limitations; comfortable at rest, but ordinary activity results in symptoms.
  • Class III: Marked limitations; comfortable at rest, but less than ordinary activity causes symptoms.
  • Class IV: Severe limitations; symptoms even at rest, and any physical activity increases discomfort.
American College of Cardiology / American Heart Association(ACC/AHA) Stage of Heart Failure:
  • Stage A: At high risk for heart failure but without structural heart disease or symptoms.
  • Stage B: Structural heart disease present but without symptoms.
  • Stage C: Structural heart disease present with prior or current symptoms of heart failure.
  • Stage D: Refractory heart failure requiring specialized interventions, often involving advanced medical therapies or transplantation.