CLASSIFICATIONS OF HEART FAILURE
By Sheryl McCormick
Heart Failure affects people to varying degrees. The New York Heart Association has categorized each of the diagnosis into four classifications. Class I and Class II are considered mild. Class III is considered moderate and Class IV is severe.
As mentioned in other articles (See “Symptoms of Heart Failure”) detecting heart failure isn’t always easy; especially in the beginning. That presents a double-edged sword. While not knowing you have heart failure can be dangerous, if you are reading this now, you are apparently aware enough to want to do something about it before it escalates. With proper diet and exercise, heart failure can be dealt with before it moves into a Class II category.
In Class I there are no restrictions of physical activity. Patients generally don’t complain of being overly tired or of experiencing shortness of breath. A patient is still able to control the disease. Regular exercise, limiting alcohol consumption, and eating healthy (with moderate sodium intake), are all actions that can be taken quite easily. High blood pressure will need to be treated. Quitting smoking is crucial.
With Class II heart failure, patients will feel slight restrictions with everyday physical actions like bending over or walking. They will be tired and shortness of breath may occur. Non-invasive surgical procedures like ACE-Inhibitors or Beta Blockers (depending on the patient), may be considered.
Class III heart failure patients experience definite limitations during physical activity. They may remain comfortable at rest, but most all physical activity will cause undue fatigue. Under physician care, their diet and exercise may be monitored. Diuretics, to combat water retention, may be prescribed.
Patients in Class IV heart failure are virtually unable to do any physical activity without discomfort. There may be significant signs of cardiac problems even while resting. Surgical options will be explored along with the same attention given to treatments in Classes I-III.
The National Heart, Lung and Blood Institute estimates that 35% of patients with Heart Failure are in functional NYHA Class I, 35% are in Class II, 25% are in Class III and 5% are in Class IV. It has been estimated that between 5 and 15 % of patients with Heart Failure have persisting sever symptoms.
Physicians and patients can work together through each of the four classes to monitor and, hopefully, control heart failure. Strict attention to physician advice and treatment(s) is strongly recommended.