← Clinical Scores and Calculators
NYHA Classification
Classify functional severity of heart failure. Guides treatment, device eligibility (ICD, CRT), and prognosis.
Indication
- Classify functional severity of heart failure. Guides treatment, device eligibility (ICD, CRT), and prognosis.
Criteria
- id: nyha_class; label: Best-fit functional class; type: options; options: value: 1; label: Class I — No limitation; ordinary activity causes no symptoms; value: 2; label: Class II — Slight limitation; ordinary activity causes symptoms; value: 3; label: Class III — Marked limitation; less than ordinary activity causes symptoms; value: 4; label: Class IV — Symptoms at rest; unable to carry on any activity
Clinical pearls
- NYHA class is dynamic — patients can improve with treatment
- NYHA III–IV with EF ≤35% are the primary candidates for CRT
- ICD for primary prevention when EF ≤35% after ≥3 months of GDMT (NYHA I–III)
- NYHA IV with no reversible cause = Stage D — transplant or LVAD evaluation
Source and review
- New York Heart Association Criteria Committee 1994; ACC/AHA HF Guidelines 2022. Last reviewed: 2025-01-01