Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
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    Patent Pending

    New York Heart Association (NYHA) Functional Classification for Heart Failure

    Stratifies severity of heart failure by symptoms.
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    When to Use
    Pearls/Pitfalls

    Patients with signs and symptoms of heart failure.

    • Often criticized for being outdated, subjective, and with limited reproducibility (56% according to one study by Goldman et al). Nevertheless, it is still commonly used in both research and clinical settings.
    • Functional class is not necessarily linked to treatment strategy; the more modern ACC/AHA Heart Failure Staging is one attempt to bridge the gap.
    No limitation of physical activity; ordinary physical activity does not cause undue fatigue, palpitation, or dyspnea
    Slight limitation of physical activity; comfortable at rest; ordinary physical activity results in fatigue, palpitation, or dyspnea
    Marked limitation of physical activity; comfortable at rest; less than ordinary activity causes fatigue, palpitation, or dyspnea
    Unable to carry on any physical activity without discomfort; symptoms of heart failure at rest; if any physical activity is undertaken, discomfort increases

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    Use objective measures of heart failure severity such as echocardiography and 6 Minute Walk Distance to further stratify functional capacity and make treatment decisions.

    Formula

    NYHA Heart Failure Classification

    Criteria

    Class I

    No limitation of physical activity; ordinary physical activity does not cause undue fatigue, palpitation, or dyspnea

    Class II

    Slight limitation of physical activity; comfortable at rest; ordinary physical activity results in fatigue, palpitation, or dyspnea

    Class III

    Marked limitation of physical activity; comfortable at rest; less than ordinary activity causes fatigue, palpitation, or dyspnea

    Class IV

    Unable to carry on any physical activity without discomfort; symptoms of heart failure at rest; if any physical activity is undertaken, discomfort increases

    Dr. Martin Dolgin

    About the Creator

    Martin Dolgin, MD, (d. 2006) was an attending physician at the Bellevue Hospital and Tisch Hospital. He also served as a member of the American College of Cardiology and American Heart Association. Dr. Dolgin’s primary research was focused on diagnosis and treatment of heart failure.

    To view Dr. Martin Dolgin's publications, visit PubMed