No, not all CHF patients are the same. Some are sicker and require more treatment than others. When treating patients, physicians need to be able to identify how severe a patient’s CHF is. For this reason, many CHF classification systems were developed. These classifications help physicians determine what a patient’s treatment plan should be. The most widely used classification system for CHF is the New York Heart Association (NYHA) classification system.
According to this system, a patient’s heart failure is rated on a scale of I to IV with “Class I” patients having the mildest symptoms and “Class IV” patients having the worst. Only about 5 percent of patients have extremely severe Class IV heart failure. However, as an overall statistic,only 30 to 50 percent of these patients are alive 5 years after the diagnosis is made.
The NYHA classification system is very useful for doc-tors and nurses who treat patients with heart failure. It helps patients and doctors tell if heart failure is improving, staying the same, or getting worse. It is also used in research studies to help tell if treatments are successful. The NYHA classification system is used worldwide. It must be emphasized that these classification methods aren’t perfect as predictors of how CHF will progress or how a patient will respond to medications.
The biggest problem is that a patient’s symptoms may not always relate to the actual severity of his or her condition. In fact, one study found that half of heart failure patients who complained of breathlessness after exercise had only mild heart abnormalities. Another confounding factor is that some patients do not report fatigue or shortness of breath after physical activity and yet they may have severe heart damage. Experts suggest that physicians be sure to consider other factors that may indicate a poorer outlook and require aggressive treatments.