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HeartMate 3 LVAD

With Full Maglev Flow Technology

Stages of Heart Failure

Recognizing the Stages of Heart Failure1

The New York Heart Association (NYHA) classifies the stages of heart failure as follows:2

No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath).

Class 1 with silhouette of man running

Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath).

Class 2 with silhouette of man walking.

Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation or dyspnea.

Class 3 with silhouette of weak man walking slowly.

Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.

Class IV with silhouette of man sitting in chair.
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Bar chart showing steps within the four stages of heart failure with recommendations on heart failure therapies based on stages.

The American College of Cardiology/American Heart Association categorize the development and progression of heart failure into 4 stages: A through D.1,3

Stage A

Patients at high risk of developing heart failure who are asymptomatic and have no identified structural or functional cardiac abnormalities.

Stage B

Patients with structural heart disease associated with the development of heart failure but who are asymptomatic.

Stage C

Patients who have current or prior symptoms of heart failure associated with underlying structural disease.

Stage D

Patients with advanced structural heart disease and marked symptoms of heart failure at rest despite optimal medical management and who require specialized interventions.

Common symptoms of the advanced heart failure patient4

  • Dyspnea
  • Right ventricular failure
  • Fatigue
  • Edema
  • Abdominal distention
  • Sleep disturbances
  • Intolerance to previously tolerated doses of ACE inhibitors and beta blockers
  • Escalating diuretics with persistent congestion

Do you have a patient you'd like to refer to a heart failure specialist? Search now

    When your evaluation confirms disease progression to advanced heart failure, act early.

    Refer your patients to an advanced heart failure center for evaluation for advanced therapies

    Refer Patients
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    References

    1. Jessup M, Brozena S. Heart failure. N Engl J Med. 2003;348:2007-2018.
    2. https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure/classes-of-heart-failure. Accessed on Dec. 10, 2020.
    3. Hunt SA, Baker DW, Chin MH, et al. ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult: Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). Circulation. 2001;104:2996-3007.
    4. AbouEzzeddine OF, Redfield MM. Who has advanced heart failure? Definition and epidemiology. Congest Heart Fail. 2011;17:1-18.

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