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New York Heart Association (NYHA) Functional Classification for Heart Failure
Grades heart failure symptom severity by physical activity limitation.
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.