Different Stages of Congestive Heart Failure

shortness of breath

Story at-a-glance -

  • The New York Heart Association Classification takes note of the symptoms of congestive heart failure patients and separates them in four categories
  • The American College of Cardiology and American Heart Association Guidelines classify patients according to the progression of the disease
  • Doctors may often use them together to help determine the appropriate treatment for your condition

Once doctors have checked potential heart patients for symptoms of congestive heart failure, and in order to determine the ideal treatment for the condition, the disease can be classified using systems conceptualized by the New York Heart Association or the American College of Cardiology and American Heart Association.1

The New York Heart Association Classification

This classification takes note of the symptoms of congestive heart failure patients and separates them into four categories:2,3

  • Class 1: The patient does not experience symptoms during typical physical activities such as walking or climbing stairs. Lifestyle changes, heart medications and regular monitoring may be utilized to prevent congestive heart failure at this point.
  • Class 2: The patient is likely comfortable at rest, but fatigue, palpitations, shortness of breath or angina (chest pains) can develop after normal physical activity. The same strategies used for Class 1 can used to prevent the disease from worsening.
  • Class 3: At this point, the patient may be comfortable only at rest, and there is a noticeable limitation of physical activity. Mild exercise may cause fatigue, palpitations or shortness of breath. Patients experiencing Class 3 symptoms must talk to a doctor immediately, since the treatment may already be complicated.
  • Class 4: A patient with Class 4 congestive heart failure has severe limitations, and may be unable to perform any amount of physical activity without experiencing symptoms such as irregular heartbeat and shortness of breath, and some indicators may be present even at rest. There is no cure for congestive heart failure at this stage, but quality-of-life and palliative care options may be considered. Consult a doctor to discuss their pros and cons.

The American College of Cardiology and American Heart Association Guidelines

These guidelines classify patients according to the progression of the disease. Oftentimes, doctors use this system to identify potential risk factors, in order to begin early and more aggressive treatment that'll help prevent or delay congestive heart failure. In these guidelines, the stages of congestive heart failure are as follows:4,5

  1. Stage A (High risk for developing heart failure): Also called "pre-heart failure," in Stage A the patient has either one or more or several risk factors for congestive heart failure, but hasn't shown symptoms yet. For example, some of the risk factors include hypertension, diabetes, metabolic syndrome and a history of alcohol or drug abuse.
  2. Stage B (Asymptomatic heart failure): In this stage, also considered pre-heart failure, the patient already has an enlarged or dysfunctional left ventricle from any cause, but is asymptomatic for heart failure symptoms (meaning no symptoms are manifesting).
  3. Stage C (Symptomatic heart failure): In this stage, the patient is now diagnosed with heart failure and experiences common symptoms of congestive heart failure such as shortness of breath, fatigue and inability to exercise. You may also have swollen feet, ankles, lower legs and abdomen, as well as weak legs.
  4. Stage D (Refractory end stage heart failure): The patient still experiences symptoms at rest, despite having been treated for congestive heart failure. As such, cardiac transplants, mechanical devices, more aggressive medical therapy or end-of-life care may be recommended.

As the Mayo Clinic emphasizes, these scoring systems aren't independent of each other. Doctors may often use them together to help determine the appropriate treatment for your condition. Try asking your doctor about your score to learn more about the severity of your congestive heart failure. He or she can interpret your score and come up with a treatment plan based on your condition.6

MORE ABOUT CONGESTIVE HEART FAILURE

Congestive Heart Failure: Introduction

What Is Congestive Heart Failure?

Congestive Heart Failure Symptoms

Congestive Heart Failure Causes

Congestive Heart Failure Stages

Congestive Heart Failure Life Expectancy

Congestive Heart Failure Treatment

Congestive Heart Failure Prevention

Congestive Heart Failure Diet

Congestive Heart Failure FAQ



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