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What Is the Last Stage of Heart Failure?

Reviewed on 8/23/2018

Ask a Doctor

Can you die of heart failure? What is the last stage of heart failure? What are some signs death is near?

Doctor's Response

You can absolutely die of heart failure. 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

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

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Reviewed on 8/23/2018
References
Dumitru, I., MD. "Heart Failure." Medscape. Updated: Jan 11, 2016.
<http://emedicine.medscape.com/article/163062-overview>
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