The American College of Cardiology and the American Heart
Association have devised a classification system for
heart failure that categorizes heart failure based on
the progression of the disease that occurs in most people. Under this system,
heart failure is classified by stages A through D.1
Person is at high risk for developing heart
failure but has no structural disorder of the heart.
high blood pressure,
coronary artery disease,
diabetes, a history of
drug or alcohol abuse, a personal history of
rheumatic fever, or a
family history of
Person has a structural disorder of the heart
but has never developed symptoms of heart failure.
Person has structural changes to the left
ventricle, has heart valve disease, or has had a
Person has past or current symptoms of heart
failure associated with underlying structural heart disease.
Person has shortness of breath or fatigue
caused by left ventricular systolic dysfunction or is without symptoms and is
receiving treatment for prior symptoms of heart failure.
Person has end-stage disease and requires
specialized treatment strategies.
Person is frequently hospitalized for heart
failure or cannot be safely discharged from the hospital; person is in the
hospital awaiting a heart transplant; person is at home receiving continuous
intravenous support for symptom relief or being supported with a mechanical
circulatory assistive device; or person is in a
hospice setting for the management of heart
Hunt SA, et al. (2009). 2009 focused update
incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management
of heart failure in adults. A report of the American College of Cardiology
Foundation/American Heart Association Task Force on Practice Guidelines.
Circulation, 119(14): e391–e479.
April 26, 2012
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
& Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
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