HF - Classification Tables

HEART FAILURE CLASSIFICATION (Page 2)
ACC/AHA Stages, Progression, and Treatment of HF, 2001
This new HF staging also includes incorporation of conditions which potentially leading to HF and cardiac structural abnormality, which should lead to more appropriate management to slow down the progression of disease and improvement of quality of life.

Stage A
- At high risk for developing of HF but without structural heart disease or symptom of HF.

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Stage B
- Structural heart disease but without symptoms of HF.

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Stage C
- Structural heart disease with prior or current symptoms of HF.
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Stage D
- Refractory HF required specialized interventions.

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e.g.. Patients with:
- Hypertension, coronary artery disease, diabetes mellitus, using cardiotoxins, FH of CM.

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e.g.. Patients with:
- previous MI, Left ventricular systolic dysfunction, asymptomatic valvular disease.

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e.g.., Patients with:
- known structural heart disease, shortness of breath and fatigue, reduced exercise tolerance.

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e.g.., Patients who:
- have marked symptom at rest despite maximal medical therapy (e.g... Those who are recurrently hospitalized or cannot be safely discharged from the hospital without specialized interventions).

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Therapy:
- Treat hypertension, encourage smoking cessation, treat lipid disorders, encourage regular exercise, discourage alcohol intake,
- ACEI in atherosclerotic vascular disease of diabetic patients.

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Therapy:
- All measures under Stage A.
- Heart failure education.
- ACEI and Beta blocker S/P MI patients regardless of EF.
- ACEI in low EF patients regardless of MI history.
- Beta blocker in symptomatic low EF regardless of MI history.
- ICD in appropriate patients.
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Therapy:
- All measures under Stage A.
- Extensive heart failure education.
- Drugs for routine used: ACEI, beta blocker, diuretic, digitalis, spironolactone,ARB, hydralazine and nitrate, etc.
- ICD/biventricular pacing in appropriate patients.

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Therapy:
- All measures under Stage A, B, and C.
- Mechanical assist devices.
- Heart transplantation.
- Continuous (not intermittent) IV inotropic infusion for palliation.
- Hospice care.

HF = Heart Failure, FH = Family History, CM = Cardiomyopathy, S/P = Status Post, MI = Myocardial Infarction,
ACEI = Angiotensin Converting Enzyme Inhibitor, ARB = Angiotensin Receptor Blocker.

Stage A - At high risk for developing of HF but without structural heart disease or symptom of HF.	.	Stage B - Structural heart disease but without symptoms of HF.	.	Stage C - Structural heart disease with prior or current symptoms of HF.	.	Stage D - Refractory HF required specialized interventions.
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e.g.. Patients with: - Hypertension, coronary artery disease, diabetes mellitus, using cardiotoxins, FH of CM.	.	e.g.. Patients with: - previous MI, Left ventricular systolic dysfunction, asymptomatic valvular disease.	.	e.g.., Patients with: - known structural heart disease, shortness of breath and fatigue, reduced exercise tolerance.	.	e.g.., Patients who: - have marked symptom at rest despite maximal medical therapy (e.g... Those who are recurrently hospitalized or cannot be safely discharged from the hospital without specialized interventions).
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Therapy: - Treat hypertension, encourage smoking cessation, treat lipid disorders, encourage regular exercise, discourage alcohol intake, - ACEI in atherosclerotic vascular disease of diabetic patients.	.	Therapy: - All measures under Stage A. - Heart failure education. - ACEI and Beta blocker S/P MI patients regardless of EF. - ACEI in low EF patients regardless of MI history. - Beta blocker in symptomatic low EF regardless of MI history. - ICD in appropriate patients.	.	Therapy: - All measures under Stage A. - Extensive heart failure education. - Drugs for routine used: ACEI, beta blocker, diuretic, digitalis, spironolactone,ARB, hydralazine and nitrate, etc. - ICD/biventricular pacing in appropriate patients.	.	Therapy: - All measures under Stage A, B, and C. - Mechanical assist devices. - Heart transplantation. - Continuous (not intermittent) IV inotropic infusion for palliation. - Hospice care.