Comparison of ACCF/AHA Stages of HF and NYHA Functional
Classifications
ACCF/AHA Stage NYHA Functional Classification
Stage A At high risk for HF but
without structural heart
disease or symptoms
of HF
None
Stage B Structural heart disease
but without signs or
symptoms of HF
Class I No limitation of physical activity.
Ordinary physical activity does
not cause symptoms of HF.
Stage C Structural heart disease
with prior or current
symptoms of HF
Class I No limitation of physical activity.
Ordinary physical activity does
not cause symptoms of HF.
Class II Slight limitation of physical
activity. Comfortable at rest, but
ordinary physical activity results
in symptoms of HF.
Class III Marked limitation of physical
activity. Comfortable at rest, but
less than ordinary activity causes
symptoms of HF.
Class IV Unable to carry on any physical
activity without symptoms of HF,
or symptoms of HF at rest.
Stage D Refractory HF requiring
specialized interventions
Class IV Unable to carry on any physical
activity without symptoms of HF,
or symptoms of HF at rest.
