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What is Heart Failure?
Classifications and Treatments
What is Heart Failure?
Heart failure is not a single disease, but the result of a number of diseases that cause damage to the heart. Heart failure is a chronic condition that occurs when the heart is unable to pump sufficient amounts of blood throughout the body. The weakened heart is characterized by dilated pumping chambers and thinning of the walls as can be seen in the picture below. In its end-stages, heart failure can severely limit the patient’s physical ability and quality of life.
Causes and Symptoms
Heart failure can result from many causes, including:
- Heart attack
- High blood pressure
- Cardiomyopathies (diseases of the heart muscle)
- Valve disease
Heart failure patients may experience symptoms such as:
- Shortness of breath
- Persistent coughing or wheezing
- Fatigue
- Increased heart rate
- Water retention
- Lack of appetite
Classifications and Treatments
The severity of congestive heart failure (CHF) can be classified into different classes or stages using either the New York Heart Association (NYHA) Functional Classification or the American College of Cardiology and American Heart Association Classification (ACC/AHA) of Chronic Heart Failure.
As CHF worsens, progressive treatment options become necessary. In general, treatments may include diet/exercise, medications, device therapy (e.g. LVAS), heart transplantation or other surgical procedures.
NYHA Functional ClassificationThe NYHA classifies heart failure into classes based on functional limitations and severity. |
|
Class |
Patient Symptoms |
Class I (Normal) |
Few observable symptoms, no limitation in ordinary physical activity. |
Class II (Mild) |
Mild observable symptoms and slight limitation during ordinary activity. Comfortable at rest. |
Class III (Moderate) |
Marked limitation in physical activity due to symptoms even during less-than-ordinary activity. Comfortable only at rest. |
Class IV (Severe) |
End-stage heart failure. Severe limitations. Experience symptoms even while at rest. |
ACC/AHA Classification of CHFThe ACC/AHA created four classifications from risk for developing the disease |
|
Stage |
Description |
A |
Hypertension, diabetes mellitus, family history, coronary artery disease |
B (Asymptomatic HF) |
Previous myocardial infarction (heart attack), valvular disorders, left ventricular dysfunction |
C |
Structural heart disease, fatigue, low tolerance level for physical activity |
D |
Severe limitations. Experience symptoms even while at rest. |