New York Heart Association (NYHA) Functional Classification

Clinical Use

Classify the extent of heart failure symptoms

Information

New York Heart Association (NYHA) Functional Classification is a simple way of classifying the severity of heart failure. It places patients in one of four categories depending on their functional capacity.

 

ClassNYHA functional classification
IPatients have cardiac disease but without the resulting limitations of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnoea or anginal pain
IIPatients have cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnoea or anginal pain
IIIPatients have cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation, dyspnoea or anginal pain
IVPatients have cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased

Reference

1.Raphael C, 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. 93 (4): 476–82. Abstract

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Developer: Sirikarn Napan, MD, FACC