The American College of Cardiology Foundation and the American Heart Association Task Force on Practice Guidelines, released the 2009 Guidelines for the Diagnosis and Management of Heart Failure in Adults. In these guidelines, the task force developed a way to classify the stages of heart failure.
Stage A
According to the American College of Cardiology Scale, patients that are in Stage A are not considered to have heart failure. Stage A was designed to give physicians guidelines to help identify patients that are at risk for heart failure. Patients in Stage A do not have any structural damage to their heart but do have hypertension, diabetes, are obese or have a metabolic syndrome. The goals for the patient include stopping smoking, treating hypertension, increasing physical activity, controlling metabolic syndrome and discouraging the use of alcohol.
Stage B
According to the American College of Cardiology Scale, patients in Stage B have structural heart damage but do not have any symptoms of heart failure. Patients in Stage B may have had a heart attack, had their left ventricle of their heart operated on and could have asymptomatic valvular disease. The goals for these patients are the same as Stage A goals but also include medications such as beta blockers for high blood pressure. Implanted defibrillators are also a treatment option for some patients in this group.
Stage C
Patients in Stage C have structural damage to the heart and have had prior or are experiencing heart failure symptoms, such as shortness of breath, according to the American College of Cardiology Scale. The goals for Stage C patients include all goals listed under Stage A and B along with a diet low in salt. Medications for these patients can include diuretics and beta blockers. Some patients will require a implanted defibrillator or biventricular pacing.
Stage D
Patients in Stage D are those who are still experiencing heart failure symptoms despite medications and other courses of treatment. These patients are frequently hospitalized and are not healthy enough to be discharged from the hospital without specialized treatment. Options for these patients include end of life care, a heart transplant, an artificial heart or enrolling in a clinical trial, according to the American College of Cardiology Scale.
New York Heart Association Scale
The New York Association Scale consists of four stages and classifies people who already have heart disease. The first stage is patients who have the mildest form of heart failure, and the fourth stage is patients who have the most severe heart failure. The American College of Cardiology Scale's first two stages are designed to identify patients who could be at risk for developing heart failure. According to the Mayo Clinic, doctors may use both scales to classify a patient's heart failure.
