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Congestive Heart Failure (cont.)

What Are the Stages of Congestive Heart Failure?

Once a diagnosis of heart failure is established, evaluation of heart failure is important. Providing a complete and accurate history of symptoms is essential. Two major groups have established various stages of congestive heart failure.

The American College of Cardiology/American Heart Association stages patients according to the progression of their heart failure. The stages are as follows:

  • Stage A: High risk for developing heart failure
    • Patient has one or more risk factors for developing heart failure.
  • Stage B: Asymptomatic heart failure
    • This stage includes patients who have an enlarged or dysfunctional left ventricle from any cause, but are asymptomatic.
  • Stage C: Symptomatic heart failure
    • Patient experiences heart failure symptoms -- shortness of breath, fatigue, inability to exercise, etc.
  • Stage D: Refractory end-stage heart failure
    • Patient has heart failure symptoms at rest in spite of medical treatment.
    • Cardiac transplantation, mechanical devices, more aggressive medical therapy, or end-of-life care may be necessary.

The New York Heart Association classifies patients based on their physical limitations. Classifications are as follows:

  • Class I: No limitations of physical activity, no symptoms with ordinary activities
  • Class II: Slight limitation, symptoms with ordinary activities
  • Class III: Marked limitation, symptoms with less than ordinary activities
  • Class IV: Severe limitation, symptoms of heart failure at rest

Risk Factors

Based on a clinical study, it was determined that one in every five people will develop heart failure in his or her lifetime. Some of the most common risk factors for heart failure include:

When to Contact a Doctor or Health Care Professional If You Think You Have This Condition

Often cardiologists, who specialize in heart failure, can work together with primary care doctors and other health care providers to diagnose and treat congestive heart failure. Certain symptoms need to be checked by a doctor. If a person has any of the symptoms listed below, they should call their health care provider for an appointment. If symptoms listed below are severe or of sudden onset, seek immediate emergency care.

  • Shortness of breath that seems to be getting worse or causes difficulty sleeping.
  • Waking up at night with shortness of breath.
  • Sleep is better in a semi-upright position in a chair or recliner than flat in bed.
  • Shortness of breath develops with mild exertion and is worse than usual.
  • Unusual fatigue that is not relieved with rest.
  • A dry cough that will not go away or seems otherwise unusual.
  • Swelling in the ankles, feet, or legs that does not go away.

Other, more subtle symptoms of heart failure that are also seen in other diseases warrant a visit to a health care provider, especially if linked to any of the symptoms already listed above. These include:

  • Abdominal bloating or discomfort
  • Persistently pale skin
  • Poor appetite

Always take chest pain seriously. Congestive heart failure, per se, usually does not cause chest pain. However, remember other serious conditions that cause chest pain, such as angina and myocardial infarction, can coexist with heart failure.

If these symptoms develop quickly or worsen rapidly, seek emergency treatment.

  • Shortness of breath
  • Severe, unrelieved chest pain
  • Swelling in the legs that becomes painful, even in one leg
  • Fainting or near-fainting
Medically Reviewed by a Doctor on 4/20/2017
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Read What Your Physician is Reading on Medscape

Heart Failure »

Heart failure is the pathophysiologic state in which the heart, via an abnormality of cardiac function (detectable or not), fails to pump blood at a rate commensurate with the requirements of the metabolizing tissues and/or pumps only from an abnormally elevated diastolic filling pressure.

Read More on Medscape Reference »


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