Table 2

ACC/AHA stages of HF

APatients at risk of developing HF because of the presence of conditions that are strongly associated with the development of HF. Such patients have no identified structural or functional abnormalities of the pericardium, myocardium or cardiac valves and have never shown symptoms or signs of HF.Systemic hypertension; coronary artery disease; diabetes mellitus; history of cardiotoxic drug therapy or alcohol abuse; personal history of rheumatic fever; family history of cardiomyopathy.
BPatients who have developed structural heart disease that is strongly associated with the development of HF but who have never shown signs or symptoms of HF.Left ventricular hypertrophy or fibrosis; left ventricular dilatation of hypocontractility; asymptomatic valvular heart disease; previous myocardial infarction.
CPatients who have current or prior symptoms of HF associated with underlying structural heart disease.Dyspnoea or fatigue due to left ventricular systolic dysfunction; asymptomatic patients who are undergoing treatment for prior symptoms of HF.
DPatients with advanced structural heart disease and marked symptoms of HF at rest despite maximal medical therapy and who require specialised interventions.Patients who are frequently hospitalised for HF or cannot be safely discharged from the hospital; patients in the hospital awaiting heart transplantation; patients at home receiving continuous intravenous support for symptom relief or being supported with a mechanical circulatory assist device; patients in a hospice setting for the management of HF.
  • ACC/AHA, American College of Cardiology/American Heart Association; HF, heart failure.