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What Is the New York Heart Association (NYHA) Functional Classification System?

Normal Stress TestThe New York Heart Association Functional Classification was first published in 1928 to help physicians communicate patients’ heart failure symptoms in a shared language. The classifications have been updated many times since 1928 to include updated medical knowledge and language, but the NYHA’s system remains the standard for heart failure classification to this day.

The New York Heart Association classifies patients into four groups. This is based on functional capacity and has to do with how much the patient’s heart disease disrupts their everyday life. These four classes describe the severity of symptoms and limitations from mild to severe.


Defining the Four Classes:

●     Class I:

Class I is mild. Shortness of breath (dyspnea) is present but does not limit an individual’s physical exertion in a significant way.

●     Class II:

Class II is also mild. There is, however, minimal disruption to everyday activity caused by dyspnea. These patients are comfortable while resting.

●     Class III:

This class categorizes patients with moderate limitation of daily activity. Although these patients may breathe easily while sitting or lying down, even small tasks such as walking to the bathroom can cause shortness of breath and abnormal tiredness.

●     Class IV:

Class IV is the most severe classification a patient can receive from the NYHA guidelines. These patients experience shortness of breath at rest. In fact, actual movement and work only increase the severity of their symptoms. These patients need hospitalization for intravenous medications to remove excess fluid buildup. This purports a poor overall prognosis.

Have further questions about the New York Heart Association’s functional classification system or want to learn more about the stages of heart disease? Give Brookhaven Heart a call at 631-654-3278 or reach us through our contact page to make your appointment today!