NYHA FUNCTIONAL CLASSIFICATION

The NYHA classifies heart failure into classes based on functional limitations and
severity.

Class

Patient Syptoms

Class I
(Normal)

Few observable symptoms, no limitation in ordinary physical activity.

Class II
(Mild)

Mild observable symptoms and slight limitation during ordinary activity.

Comfortable at rest.

Class III
(Moderate)

Marked limitation in physical activity due to symptoms even during lessthan-ordinary activity. Comfortable only at rest.

Class IV
(Severe)

End-stage heart failure. Severe limitations. Experience symptoms even

while at rest.

ACC/AHA CLASSIFICATION OF CHF

The ACC/AHA created four classifications from risk for developing the disease
to severe disability.

Stage

Description

A
(High risk for developing CHF)

Hypertension, diabetes mellitus, family history, coronary

artery disease

B
(Asymptomatic HF)

Previous myocardial infarction (heart attack), valvular

disorders, left ventricular dysfunction

C
(Symptomatic HF)

Structural heart disease, fatigue, low tolerance level for

physical activity

D
(Refractory end-stage HF)

Severe limitations. Experience symptoms even while at rest.