ToolsCalculators
New York Heart Association (NYHA) Functional Classification for Heart Failure
New York Heart Association (NYHA) Functional Classification for Heart Failure
Functional class
ResultClass I
No limitation of physical activity; ordinary activity does not cause undue fatigue, palpitation, or dyspnoea.
When to use
- Grading symptom-related functional limitation in patients with known heart failure.
- Following symptomatic response to therapy over time.
Formula
Class assigned from history alone: I no limitation; II slight limitation, symptomatic with ordinary activity; III marked limitation, symptomatic with less-than-ordinary activity; IV symptomatic at rest.
Pearls and pitfalls
- Based entirely on symptoms, not on objective measures of cardiac function.
- Inter-observer agreement is only moderate; a trend over time in the same patient is more informative than a single reading.
References
- The Criteria Committee of the New York Heart Association. Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels, 9th ed. Boston: Little, Brown & Co; 1994.