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New York Heart Association (NYHA) Functional Classification

Functional Capacity By Class             Objective Assessment*

                                                                                                                                            * Measures such as EKG, stress test, x-ray, echocardiogram, and/or radiologic images.

I

No limitation in physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea, or anginal pain.

II

Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath).

III

Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea.

IV

Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.

A

No objective evidence of cardiovascular disease. No symptoms and no limitation in ordinary physical activity.

B

Objective evidence of minimal cardiovascular disease. Mild symptoms and slight limitation during ordinary activity. Comfortable at rest.

C

Objective evidence of moderately severe cardiovascular disease. Marked limitation in activity due to symptoms, even during less-than-ordinary activity. Comfortable only at rest.

D

Objective evidence of severe cardiovascular disease. Severe limitations. Experiences symptoms even while at rest.

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