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The New York Heart Association Functional Classification, or NHYA for short, is a simple way for your doctor or nurse to classify your heart failure. It is based on your physical ability to do things, as well as other potential symptoms like your breathing and shortness of breath. It is a useful method to assess your condition, as the measurements are mainly based on observation.

The reason why the NYHA scale is important to you is twofold.

1. It helps you understand how your symptoms impact your quality of life, thereby increasing your awareness of what you might be able to do to influence them.
2. The NYHA scale is used by regulatory bodies like the National Institute of Health and Care Excellence (NICE) and SIGN in Scotland. You might be wondering why this matters to you; please read on. NICE develops pathways, which are agreed best practices for management and are evidence-based. The most current and effective methods for handling long-term chronic heart failure can be found on the  NICE Chronic Heart Failure Guidance web page. To get further information on treatment and care please read our Patient Charter, developed by patients like you living with heart failure

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Remember the more knowledge you have about your condition the better you get at managing it.

• NYHA I – No limitation of physical activity. Ordinary physical activity does not cause undue tiredness, palpitations, or shortness of breath.
• NYHA II – Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in tiredness, palpitations, or shortness of breath.
• NYHA III – You are comfortable at rest, but less than ordinary activity causes tiredness, palpitations, or shortness of breath.
• NYHA IV – You are unable to carry out any physical activity without discomfort and are tired and short of breath even at rest. If any physical activity is undertaken, discomfort is increased.

SO HOW DO YOU INTERPRET WHAT LEVEL YOU ARE?

In our experience, people living with heart failure sometimes focus too much on the numbers; let your doctors and nurses interpret their relevance. Observation plays a significant role in heart failure management by healthcare professionals, so it is important for you to observe yourself. If you are newly diagnosed, you could be at NYHA 4, but with proper management, you might be at NYHA 1 within 12 months. You may have well-managed heart failure symptoms where you fluctuate between NYHA 2 and NYHA 3, so you will probably recognise when you are in 3 rather than 2. Heart failure is a condition that can be great four days a week and challenging three days a week.