The Cardiovascular
ToolsCalculators

ACC/AHA heart failure staging

Assigns heart failure stage A through D.

ACC/AHA heart failure staging
Risk factors for HF (hypertension, diabetes, CAD, obesity, cardiotoxins, family history of cardiomyopathy)
Structural heart disease, reduced EF, or elevated filling pressures/biomarkers WITHOUT HF symptoms
Current or prior symptoms/signs of heart failure
Advanced/refractory HF requiring specialized interventions (inotropes, MCS, transplant, palliative care)
ResultNo stage

No stage criteria met.

Stage
None

When to use

  • Framing heart failure prevention and treatment along the A-D disease continuum.

Formula

A: risk factors only. B: structural/functional abnormality, no symptoms. C: current or prior HF symptoms. D: advanced, refractory HF. The highest applicable stage is assigned.

Pearls and pitfalls

  • Stages are unidirectional: a patient who has ever had symptoms remains at least stage C even when compensated.

References

  1. Heidenreich PA, et al. 2022 AHA/ACC/HFSA Heart Failure Guideline. Circulation. 2022;145(18):e895-e1032.