Right heart failure classification: Difference between revisions

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Latest revision as of 00:02, 30 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby; Jad Z Al Danaf

Overview

There are many different ways to categorize right , which includes whether the abnormality is due to insufficient contraction (systolic dysfunction); or due to insufficient relaxation of the heart (diastolic dysfunction), or to both; whether the problem is primarily increased venous back pressure (preload), or failure to supply adequate arterial perfusion (afterload); whether the abnormality is due to low cardiac output with high systemic vascular resistance or high cardiac output with low vascular resistance (low-output heart failure vs. high output cardiac failure); degree of functional impairment conferred by the abnormality (as reflected in the New York Heart Association Functional Classification^[1]); and the degree of coexisting illness: i.e. heart failure/systemic hypertension, heart failure/pulmonary hypertension, heart failure/diabetes, heart failure/chronic renal failure, etc.

Classification

Right heart failure can be functionally classified according to the New york heart association functional classification - NYHA (I-IV) or structurally according to the American College of Cardiology/ American Heart Association – ACC/AHA (stage A, B, C and D).
The ACC staging system is useful in that Stage A encompasses "pre-heart failure" — a stage where intervention with treatment can presumably prevent progression to overt symptoms. ACC Stage A does not have a corresponding NYHA class. ACC Stage B would correspond to NYHA Class I. ACC Stage C corresponds to NYHA Class II and III, while ACC Stage D overlaps with NYHA Class IV.

Functional NYHA Classification

According to the New york heart association functional classification, the classes (I-IV) are:

Class I	No limitation is experienced in any activities; there are no symptoms from ordinary activities
Class II	Slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion
Class III	Marked limitation of any activity; the patient is comfortable only at rest
Class IV	Any physical activity brings on discomfort and symptoms occur at rest

ACA/AHA Classification

According to the American College of Cardiology/American Heart Association working group, the stages (A-D) are:^[2]

Stage A	Patients at high risk for developing HF in the future but no functional or structural heart disorder
Stage B	A structural heart disorder but no symptoms at any stage
Stage C	Previous or current symptoms of heart failure in the context of an underlying structural heart problem, but managed with medical treatment
Stage D	Advanced disease requiring hospital-based support, a heart transplant or palliative care

References

↑ Criteria Committee, New York Heart Association. Diseases of the heart and blood vessels. Nomenclature and criteria for diagnosis, 6th ed. Boston: Little, Brown and Co., 1964;114.
↑ Hunt SA, Abraham WT, Chin MH; et al. (2005). "ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult" (PDF). Circulation. 112 (12): e154–235. doi:10.1161/CIRCULATIONAHA.105.167586. PMID 16160202.

Template:WH Template:WS

[1] Criteria Committee, New York Heart Association. Diseases of the heart and blood vessels. Nomenclature and criteria for diagnosis, 6th ed. Boston: Little, Brown and Co., 1964;114.

[Hunt-2005-2] Hunt SA, Abraham WT, Chin MH; et al. (2005). "ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult" (PDF). Circulation. 112 (12): e154–235. doi:10.1161/CIRCULATIONAHA.105.167586. PMID 16160202.

[1]

[2]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Right heart failure}}
-{{CMG}}
+{{CMG}}; {{AE}} [[User:Rim Halaby|Rim Halaby]]; [[User:Jad Z Al Danaf|Jad Z Al Danaf]]
 ==Overview==
-There are many different ways to categorize [[Right heart failure]], including:
+There are many different ways to categorize right , which includes whether the abnormality is due to insufficient [[Muscle contraction|contraction]] ([[systolic dysfunction]]); or due to insufficient [[relaxation]] of the heart ([[diastolic dysfunction]]), or to both; whether the problem is primarily increased venous back pressure ([[Preload_(cardiology)|preload]]), or failure to supply adequate arterial perfusion ([[afterload]]); whether the abnormality is due to low [[cardiac output]] with high [[systemic vascular resistance]] or high [[cardiac output]] with low vascular resistance (low-output heart failure vs. [[high output cardiac failure]]); degree of functional impairment conferred by the abnormality (as reflected in the [[New York Heart Association Functional Classification]]<ref>Criteria Committee, New York Heart Association. ''Diseases of the heart and blood vessels. Nomenclature and criteria for diagnosis, 6th ed.'' Boston: Little, Brown and Co., 1964;114.</ref>); and the degree of coexisting illness: i.e. [[heart failure]]/[[systemic hypertension]], [[heart failure]]/[[pulmonary hypertension]], [[heart failure]]/[[diabetes]], [[heart failure]]/[[chronic renal failure]], etc.
-*Whether the abnormality is due to insufficient [[Muscle contraction|contraction]] ([[systolic dysfunction]]), or due to insufficient relaxation of the heart ([[diastolic dysfunction]]), or to both.
-*Whether the problem is primarily increased venous back pressure ([[Preload_(cardiology)|preload]]), or failure to supply adequate arterial perfusion ([[afterload]]).
-*Whether the abnormality is due to low cardiac output with high [[systemic vascular resistance]] or high cardiac output with low vascular resistance (low-output heart failure vs. high-output heart failure).
-*The degree of functional impairment conferred by the abnormality (as reflected in the [[New York Heart Association Functional Classification]]<ref>Criteria Committee, New York Heart Association. ''Diseases of the heart and blood vessels. Nomenclature and criteria for diagnosis, 6th ed.'' Boston: Little, Brown and Co., 1964;114.</ref>)
-*The degree of coexisting illness: i.e. heart failure/systemic hypertension, heart failure/pulmonary hypertension, heart failure/diabetes, heart failure/renal failure, etc.
 ==Classification==
+*Right heart failure can be functionally classified according to the [[New york heart association functional classification]] - [[NYHA]] (I-IV) or structurally according to the [[American College of Cardiology]]/ [[American Heart Association]] – [[ACC]]/[[AHA]] (stage A, B, C and D).
+*The [[ACC]] staging system is useful in that Stage A encompasses "pre-heart failure" — a stage where intervention with treatment can presumably prevent progression to overt symptoms. [[ACC]] Stage A does not have a corresponding [[NYHA]] class. [[ACC]] Stage B would correspond to [[NYHA]] Class I. [[ACC]] Stage C corresponds to [[NYHA]] Class II and III, while [[ACC]] Stage D overlaps with [[NYHA]] Class IV.
-===''Functional'' classification===
+===Functional NYHA Classification===
-According to the '''New York Heart Association functional classification''', the classes (I-IV) are:
+According to the [[New york heart association functional classification]], the classes (I-IV) are:
-* Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities
-* Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion
-* Class III: marked limitation of any activity; the patient is comfortable only at rest
-* Class IV: any physical activity brings on discomfort and symptoms occur at rest
+{|class="wikitable" border="1"
+|-
+|'''Class I'''
+|No limitation is experienced in any activities; there are no symptoms from ordinary activities
+|-
+|'''Class II'''
+|Slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion
+|-
+|'''Class III'''
+|Marked limitation of any activity; the patient is comfortable only at rest
+|-
+|'''Class IV'''
+|Any physical activity brings on discomfort and symptoms occur at rest
+|}
+===ACA/AHA Classification===
 According to the [[American College of Cardiology]]/[[American Heart Association]] working group, the stages (A-D) are:<ref name="Hunt-2005">{{cite journal |author=Hunt SA, Abraham WT, Chin MH, ''et al.'' |title=ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult |journal=Circulation |volume=112 |issue=12 |pages=e154–235 |year=2005 |pmid=16160202 |doi=10.1161/CIRCULATIONAHA.105.167586 |url=http://circ.ahajournals.org/cgi/reprint/112/12/e154.pdf |format=PDF}}</ref>
-* Stage A: Patients at high risk for developing HF in the future but no functional or structural heart disorder.
-* Stage B: a structural heart disorder but no symptoms at any stage.
-* Stage C: previous or current symptoms of heart failure in the context of an underlying structural heart problem, but managed with medical treatment.
-* Stage D: advanced disease requiring hospital-based support, a heart transplant or [[palliative care]].
-The ACC staging system is useful in that Stage A encompasses "pre-heart failure" — a stage where intervention with treatment can presumably prevent progression to overt symptoms. ACC Stage A does not have a corresponding NYHA class. ACC Stage B would correspond to NYHA Class I. ACC Stage C corresponds to NYHA Class II and III, while ACC Stage D overlaps with NYHA Class IV.
+{|class="wikitable" border="1"
+|-
+|'''Stage A'''
+|Patients at high risk for developing HF in the future but no functional or structural heart disorder
+|-
+|'''Stage B'''
+|A structural heart disorder but no symptoms at any stage
+|-
+|'''Stage C'''
+|Previous or current symptoms of heart failure in the context of an underlying structural heart problem, but managed with medical treatment
+|-
+|'''Stage D'''
+|Advanced disease requiring hospital-based support, a heart transplant or [[palliative care]]
+|}
+==References==
+{{Reflist|2}}
+{{WH}}
+{{WS}}
+[[Category:Disease]]
+[[Category:Cardiology]]
+[[Category:Pulmonology]]
+[[Category:Up-To-Date]]
+[[Category:Up-To-Date cardiology]]