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Congestive Heart Failure (cont.)

Congestive Heart Failure Stages

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
Medically Reviewed by a Doctor on 2/10/2016
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