NYHA Classes
Intermacs
American College of Cardiology 4 stages of Heart Failure
Heart Failure Classification by EF
Cardiogenic Shock
100
Heart failure is a clinical syndrome with current or prior symptoms or signs caused by a structural and/or functional cardiac and is corroborated by this lab.

What is elevated BNP (natriuretic peptide)?

100

The modifier code designated to patients requiring frequent emergency visits or hospitalizations for IV diuretics, ultrafiltration, or brief inotropic therapy.

What is FF?

100

This stage is characterized by structural disease but no signs or symptoms of heart failure.

What is Stage B?

100

This heart classification by EF affects more women than men.

What is HFmrEF (HF with mildly reduced EF)?

100

This stage is a patient in that manifest with hypoperfusion that requires interventions such as inotropes, pressors, and/or mechanical support / ECMO beyond volume resuscitation to restore perfusion.

What is Stage C Classic Cardiogenic Shock?

200

This heart failure has a 10-15% 1 year mortality.

What is Class II?

200

This Intermacs patient profile corresponds with the SCAI Shock stage E.

What is Crash and Burn or Intermacs 1?

200

This is a patient with known risks of heart failure such hypertension, CVD, diabetes, obesity, exposure to cardiotoxic agents, genetic variant for cardiomyopathy or family history of cardiomyopathy, but without current or previous symptoms/signs of HF and without structural/functional heart disease or abnormal biomarkers.

What is Stage A?

200

This heart failure has LVEF of 41-49%

What is HF with mildly reduced EF?

200

This wedge is indicative of cardiogenic shock?

What is 18 mmHg?

300

This class has marked limitation of physical activity.  They are comfortable at rest but less than activity causes fatigue, palpitation, and dyspnea.

What is Class III?

300

The patient profile to describe the patient dependent on inotropic support who continues to deteriorate in nutrition, renal function, fluid retention with refractory volume overload.

What is the Intermacs 2: progressive decline / sliding on inotropes patient profile?

300

The stage of HF is characterized by worsening HF symptoms that interfere with daily life and with recurrent hospitalization despite attempts to optimize GDMT.

What is stage D?

300

This heart failure classification is characterized by LVEF >50% and evidence of spontaneous or provokable increased LV filling pressures and elevated natriuretic peptide.

What is HFpEF (HF with preserved EF)?

300

This is the downward spiral of progressive hypoperfusion, organ dysfunction, and shock driven by accumulated metabolic derangements.

What is the death spiral of cardiogenic shock?

400

These three drugs for patients with advancing heart failure are considered routine?

What is Diuretics, ACEI and Betablockers?

400

7

What is the number of patient profiles in the Intermacs?

400

This stage is characterized by ventricular hypertrophy and shortness of breath, elevated biomarkers indicative of acute coronary syndrome.

What is stage C?

400

This HF is managed by four main drug classes; renin-angiotensin system inhibitors, evidence-based B-blockers, mineralocorticosteroid inhibitors, and sodium glucose cotransporter 2 inhibitors.

What is HFrEF?

400

This remains a leading cause of death among patients with acute myocardial infarction.

What is cardiogenic shock?

500

This level is characterized by persistent cough, Paroxysmal nocturnal dyspnea, swelling and cognitive change.

What is NYHA level IV?

500

This NYHA scale correlates with Intermacs 7 where a patient has limited activity with mild physical exertion while patient is living comfortably at home. 

What is advanced NYHA class III?

500

This stage correlates with the NYHA class I.

What is stage B?

500

This hemodynamic index indicates a heart failure patient is moving from congestion to hypoperfusion.

What is CPO <0.6?

500

This profile (a low CI, an elevated systemic vascular resistance, and a high PCWP) is the most frequent CS phenotype, accounting for nearly two thirds of patients with MI-associated CS.

What is classic “cold and wet” cardiogenic shock?