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What Is Class D Heart Failure?

In November of 2001, the American College of Cardiology, in partnership with the American Heart Association, released a system for classifying heart failure in individuals. This system can be used in conjunction with the functional class system that was already in place. This newer system puts heart failure in stages A through D.

  1. Two Methods of Classifying

    • Heart failure is different in every afflicted individual. Doctors use two methods in measuring the disease. The first identifies how symptoms affect your ability to function and perform basic tasks. The second indicates what stage of progression the heart failure is in.

    Functional Capacity

    • The functional capacity is measured in classes from I to IV. I means no limitations and indicates that the individual can do normal physical activity with no symptoms. Level IV indicates an inability to perform tasks without discomfort, and even at rest symptoms are experienced.

    Staging Classification

    • The staging system is used to focus on the progression of the disease over time. It was designed to help physicians identify the risk level of individuals. Those in the earlier stages (A and B) may be at risk for heart failure or even actually have some heart damage. However, they do not have heart failure symptoms. This label can inform doctors about the course of treatment to take. In these first two stages, the goal is prevention of heart failure.

    Stages

    • Stage C is an intermediate stage. It describes a patient with past or current heart failure symptoms and underlying structural heart disease. Stage D is used for an individual who has end-stage disease. This patient is often hospitalized for heart failure. They need special care and treatment, including possible heart transplant or hospice care. Stage D is the most emergent stage of heart failure. In this stage, the symptoms of pain, shortness of breath, fatigue and palpitations are present most of the time.

    Description

    • Once someone moves to a higher stage, they stay in that stage or progress to the next. They cannot be put into a lower stage. A patient does not become stage C and then become stage B, even if their symptoms abate. If there is a decrease in evidence of heart failure, the functional class (I-IV) will improve, but the stage will remain the same .

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