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Classification for Congestive Heart Failure, New York Heart Association

New York Heart Association’s (NYHA) Functional Classification for Congestive Heart Failure (CHF)#

Adapted from: NYHA Classes of Heart Failure. American Heart Association.

The New York Heart Association (NYHA) Functional Classification provides a simple way of classifying heart disease (originally cardiac failure), useful for preoperative assessment. It places patients in one of four categories, based on how much they are limited during physical activity:

Patient Symptoms#

  • Class I: No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath).
  • Class II: Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath).
  • Class III: Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea.
  • Class IV: Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.

Objective Assessment#

  • Class A: No objective evidence of cardiovascular disease. No symptoms and no limitation in ordinary physical activity.
  • Class B: Objective evidence of minimal cardiovascular disease. Mild symptoms and slight limitation during ordinary activity. Comfortable at rest.
  • Class C: Objective evidence of moderately severe cardiovascular disease. Marked limitation in activity due to symptoms, even during less-than-ordinary activity. Comfortable only at rest.
  • Class D: Objective evidence of severe cardiovascular disease. Severe limitations. Experiences symptoms even while at rest.

Related Pages#