A touch of class
There are two organizations that have classifications for CHF. The American College of Cardiology (ACC)/American Heart Association (AHA) classifies CHF as:
* High risk of developing heart failure: This includes hypertension, diabetes, CAD, and family history of cardiomyopathy.
* Asymptomatic heart failure: Candidates for this level are those with a previous history of myocardial infarction (MI), left ventricular dysfunction, and valvular heart disease.
* Symptomatic heart failure: These are patients with structural heart failure, dyspnea and fatigue, and impaired exercise tolerance.
* Refractory end-stage heart failure: These individuals have marked symptoms at rest despite maximal medical therapy.
Similarly, the New York Heart Association heart failure classification also has four classes:
* Class I (mild): No limitation of physical activity; ordinary physical activity doesn't cause tiredness, heart palpitations, or shortness of breath.
* Class II (mild): Slight limitation of physical activity; the patient is comfortable at rest, but ordinary activity causes tiredness, heart palpitations, and/or shortness of breath.
* Class III (moderate): Marked limitations of physical activity; the patient is comfortable at rest, but less than ordinary physical activity causes tiredness, heart palpitations, or shortness of breath.
* Class IV (severe): Severe limitation of physical activity; the patient is unable to carry out any physical activity without discomfort. Symptoms are present at rest, and any physical activity increases that discomfort