New York Heart Association Functional Classification
The New York Heart Association (NYHA) Functional Classification provides a simple way of classifying the extent of heart failure. It places patients in one of four categories based on how much they are limited during physical activity; the limitations/symptoms are in regard to normal breathing and varying degrees in shortness of breath and/or angina pain.
It originated in 1928, when no measurements of cardiac function were possible, to provide a common language for physicians to communicate. Despite difficulties in applying it, such as the challenge of consistently classifying patients in class II or III, because functional capacity is such a powerful determinant of outcome it remains arguably the most important prognostic marker in routine clinical use in heart failure today.
|I||Cardiac disease, but no symptoms and no limitation in ordinary physical activity, e.g. no shortness of breath when walking, climbing stairs etc.|
|II||Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity.|
|III||Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20–100 m).
Comfortable only at rest.
|IV||Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients.|
Another frequently used functional classification of cardiovascular disease is the Canadian Cardiovascular Society grading of angina pectoris.
- The Criteria Committee of the New York Heart Association. (1994). Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels. (9th ed.). Boston: Little, Brown & Co. pp. 253–256.
- "Classification of Functional Capacity and Objective Assessment". Retrieved 27 October 2013.
- Raphael, Claire; Briscoe, C; Davies, J; Ian Whinnett, Z; Manisty, C; Sutton, R; Mayet, J; Francis, DP (April 2007). "Limitations of the New York Heart Association functional classification system and self-reported walking distances in chronic heart failure.". Heart (British Cardiac Society) 93 (4): 476–82. doi:10.1136/hrt.2006.089656. PMC 1861501. PMID 17005715.