New York Heart Association Functional Classification
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The New York Heart Association (NYHA) Functional Classification[1] provides a simple way of classifying the extent of heart failure. It places patients in one of four categories based on how much they are limited during physical activity; the limitations/symptoms are in regards to normal breathing and varying degrees in shortness of breath and or angina pain.
It originated in 1928,[2] when no measurements of cardiac function were possible, to provide a common language for physicians to communicate. Despite difficulties in applying it, such the challenge of consistently classifying patients in class II or III,[3] because functional capacity is such a powerful determinant of outcome it remains arguably the most important prognostic marker in routine clinical use in heart failure today.
NYHA Class | Symptoms |
---|---|
I | Cardiac disease, but no symptoms and no limitation in ordinary physical activity, e.g. shortness of breath when walking, climbing stairs etc. |
II | Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity. |
III | Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20–100 m). Comfortable only at rest. |
IV | Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients. |
Another frequently used functional classification of cardiovascular disease is the Canadian Cardiovascular Society grading of angina pectoris.
References
- ^ The Criteria Committee of the New York Heart Association. (1994). Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels (9th ed.). Boston: Little, Brown & Co. pp. 253–256.
- ^ "Classification of Functional Capacity and Objective Assessment". Retrieved 27 October 2013.
- ^ Raphael, Claire (April 2007). "Limitations of the New York Heart Association functional classification system and self-reported walking distances in chronic heart failure". Heart (British Cardiac Society). 93 (4): 476–82. doi:10.1136/hrt.2006.089656. PMC 1861501. PMID 17005715.
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