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As heart failure worsens, symptoms become more obvious and can severely impact the lives of those living with the disease.

Symptoms can include:

  • Shortness of breath
  • Persistent coughing or wheezing
  • Fatigue
  • Increased heart rate
  • Water retention
  • Lack of appetite


Heart Failure

This chronic condition, also known as congestive heart failure, affects more than 11 million people worldwide.

Heart failure patients, as well as their families and loved ones, are impacted greatly by this condition. It’s the number one reason for hospitalization, and the numbers of lives touched by the disease continues to grow with at least one million new heart failure patients diagnosed each year.

Heart failure occurs as the heart becomes progressively weaker over time and can’t pump enough blood to the rest of the body. It isn’t a single disease, but the result of a number of diseases or medical events that can cause damage to the heart. These typically include heart attack, persistent high blood pressure, valve disease and cardiomyopathies (diseases of the heart muscle).

The heart itself also changes as heart failure progresses. The chambers of the heart that pump blood become larger than normal, and the walls of those chambers are thinner than normal, as shown in the picture below.

Normal Heart vs. Heart Failure

To help determine the best course of treatment for heart failure, physicians use two different systems to define the severity of the disease.

The New York Heart Association (NYHA) Functional Classification scale classifies heart failure into one of four categories based on symptoms. NYHA Class I heart failure is when individuals can perform everyday activities without experiencing any symptoms. The most severe category is NYHA Class IV, when individuals experience symptoms even while at rest.

The American College of Cardiology (ACC) and American Heart Association (AHA) Classification of Chronic Heart Failure scale focuses on the physical functioning of the heart. It includes four categories ranging from Stage A for individuals who are at risk for developing heart failure, to Stage D for individuals with severe limitations who experience symptoms even while at rest.


Treatment for early stages of heart failure may include lifestyle changes and medications. However, as heart failure gets worse, other treatment may be needed to help the heart pump more efficiently. This may involve surgery to implant a medical device or other surgical procedures to repair the damaged heart.

The most severely ill patients need heart transplants in order to recover. Unfortunately, many patients die waiting for a transplant due to the shortage of donor hearts. More than 8,000 people worldwide are on the list of eligible candidates for heart transplants annually, but less than 4,000 will receive a transplant each year.

A large number of people who suffer from severe heart failure do not qualify for transplantation due to other health issues. The only alternative for these patients is access to a type of mechanical circulatory support called a Left Ventricular Assist System, or LVAS. The LVAS system features a special pump that helps the weakened heart circulate blood throughout the body.

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NYHA and ACC/AHA Classification Systems
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