New york heart association functional classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The New York Heart Association (NYHA) Functional Classification provides a simple way of classifying the extent of heart failure. It places patients in one of four categories based on how much they are limited during physical activity.

New York Heart Association Functional Classification (NYHA)

Class	New York Heart Association Functional Classification
Class I	No limitation: Heart disease exists with no symptoms or limitation of physical activity. Ordinary physical activity does not cause angina, fatigue, palpitation, or dyspnea that limit activity.
Class II	Minimal limitation: There is slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in angina, fatigue, palpitation, or dyspnea.
Class III	Marked limitation: Patients have marked limitation of physical activity. Comfortable at rest, but less than ordinary activity, such as walking 20–100 m, causes fatigue, palpitation, or dyspnea.
Class IV	Extreme limitation: Severe limitation; unable to carry out any physical activity without discomfort. Angina and/or symptoms of cardiac insufficiency may be present at rest. If any physical activity is undertaken, discomfort is increased. Usually self-confined to bed or a chair.

See also

• Canadian Cardiovascular Society grading scale of angina pectoris

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