New York Heart Association (NYHA) classification
This classification is symptom-based and has primarily been used as shorthand to describe functional limitations. Heart failure symptoms may progress from one class to the next in a given patient, but can also follow the path in reverse; for example, a patient with NYHA class IV symptoms might have quick improvement to class III with diuretic therapy alone.
Class I: Mild. No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitations, or dyspnea.
Class II: Mild. Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue, palpitations, or dyspnea.
Class III: Moderate. Marked limitation of physical activity. Comfortable at rest, but gentle activity causes fatigue, palpitations, or dyspnea.
Class IV: Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency at rest. If any physical activity is undertaken, discomfort is increased.
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