The New York Heart Association functional classification system for heart failure divides people into one of four classes based on their capacity for physical activity. The classes are enumerated from I through IV, with I being the highest level of functional capacity and IV being the lowest. People with class II heart failure are comfortable and free of heart-related symptoms at rest, but physical activities are slightly limited by heart-related symptoms.
Fatigue
As it relates to heart failure, fatigue is a state of exhaustion resulting from a physical effort. It typically leaves people feeling tired and unable to perform any other physical activity without a significant period of rest. According to "The Merck Manual for Healthcare Professionals," examples of activities people with class II heart failure can usually perform without developing significant fatigue or other heart-related symptoms include gardening, ascending one flight of stairs, walking at a normal pace on level ground, and sexual intercourse.
Heart Palpitations
Heart palpitation may occur with strenuous, ordinary physical activity in people with class II heart failure, notes the American Heart Association. Heart palpitations are a conscious awareness of the heartbeat, which may be perceived as excessively fast or forceful, or irregular. People commonly describe palpitations as pounding, galloping, racing or fluttering. Activities that may precipitate heart palpitations in someone with class II heart failure include climbing two flights of stairs, walking briskly uphill or shoveling snow.
Shortness of Breath
Shortness of breath is a common symptom that limits ordinary physical activity among people with class II heart failure. "The Merck Manual for Healthcare Professionals" advises that carrying heavy objects, jogging, skiing or turning soil is likely to precipitate shortness of breath or other heart-related symptoms in people with class II heart failure.
Angina
Many people with heart failure have coronary artery disease, which is narrowing of the blood vessels that supply the heart with oxygen and nutrients. At rest, the amount of blood supplied to the heart is sufficient to meet the heart's needs. However, with physical exertion, the heart must beat harder and faster. The increased workload on the heart requires increased oxygen supply. When oxygen needs are unmet, heart pain--angina--develops. According to the American Heart Association's General Physical Activity Table, comfortable activities for someone with class II heart failure include walking the dog, water aerobics, ballroom dancing and playing golf. Activities that are likely to induce heart-related symptoms such as angina include backpacking, step aerobics, singles tennis, basketball and soccer.
References
- National Heart, Lung and Blood Institute: What is Heart Failure?
- American Heart Association: Heart Failure Classification
- American Heart Association: 1994 Revisions to Classification of Functional Capacity and Objective Assessment of Patients with Diseases of the Heart
- American Heart Association: Classification of Functional Capacity and Objective Assessment
- American Heart Association: General Physical Activities Defined by Level of Intensity
