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Heart Failure Stages


Topic Overview

The American College of Cardiology and the American Heart Association have devised a classification system for heart failure that categorizes heart failure based on the progression of the disease that occurs in most people. Under this system, heart failure is classified by stages A through D.1

Stages of heart failure

Stage

Definition

Examples

A

Person is at high risk for developing heart failure but has no structural disorder of the heart.

Person has high blood pressure, coronary artery disease, diabetes, a history of drug or alcohol abuse, a personal history of rheumatic fever, or a family history of cardiomyopathy.

B

Person has a structural disorder of the heart but has never developed symptoms of heart failure.

Person has structural changes to the left ventricle, has heart valve disease, or has had a heart attack.

C

Person has past or current symptoms of heart failure associated with underlying structural heart disease.

Person has shortness of breath or fatigue caused by left ventricular systolic dysfunction or is without symptoms and is receiving treatment for prior symptoms of heart failure.

D

Person has end-stage disease and requires specialized treatment strategies.

Person is frequently hospitalized for heart failure or cannot be safely discharged from the hospital; person is in the hospital awaiting a heart transplant; person is at home receiving continuous intravenous support for symptom relief or being supported with a mechanical circulatory assistive device; or person is in a hospice setting for the management of heart failure.

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