After the physical exam, blood and heart tests have
been completed and a diagnosis of HF is confirmed, the
physician usually will classify, or "rank," the patient's
heart failure. The ranking is based on how severe the
The most commonly used system to classify heart failure
is called the New York Heart Association (NYHA) Functional
Classification. Heart failure patients are placed in one
of four categories, depending on how their condition affects
the performance of normal physical activities. The four
I: People in this category feel no symptoms and can
perform ordinary physical activity without any limitations.
Approximately 35 percent of people with heart failure
are in Class I.
Class II: Another 35 percent of people with heart
failure are in Class II. They have mild symptoms, such
as occasional swelling (edema), and may be somewhat limited
in their ability to exercise or do other strenuous activities.
They do not feel any symptoms when they are at rest.
Class III: These individuals are noticeably limited
in their ability to exercise or participate in mildly
strenuous activities. They are comfortable only when they
are at rest. About 25 percent of people with heart failure
are in this class.
Class IV: The most severe form of heart failure
occurs in about 5 percent of patients. These individuals
are severely limited in their ability to perform any activity,
and they have symptoms even when they are resting.