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Class 4: Inability to carry on any physical activity without discomfort, with any physical activity increased discomfort is experienced (symptomatically? severe? heart failure)

NYHA Class NYHA Symptom Description

NYHA Class I Asymptomatic

NYHA Class II Mildly symptomatic

NYHA Class IIIa Moderately symptomatic

NYHA Class IIIb Moderately symptomatic with recent rest dyspnea

NYHA Class IV Symptoms at rest
Physicians often find patients difficult to assign to one

NYHA class and frequently identify patients as belonging to multiple classes (e.g., II/III or III/IV). A treatment scheme based upon more specific symptoms may be easierto apply.

NYHA classification as demonstrated below removes the ambiguity of assigning mild or moderate to a patientís symptoms.