Wednesday, December 30, 2015

NYHA Classification for heart failure mnemonic and practicals tip

Greetings everyone!

I was reading about Congestive Heart Failure today and thought of sharing a practicals pearl with you guys.. NYHA class should always be mentioned when you are presenting a case of CHF.

Case presentation tip: While presenting your case, instead of just saying "Patient belongs to NYHA Class III" you could say, "Patient is categorized into NYHA Class III, which means the patient is comfortable at rest, but is limited on exertion."
This shows you know what you are talking about and the examiner won't stop and ask about all the classes :)
You should do the same when it comes to other diseases.

Your professor may ask - How did you come to know that the patient belongs to Class III?

In that case, you can explain that you asked the patient which activities he was able to do previously and can not do them anymore or what the patient told you (Patient mentioned walking to the kitchen to grab a glass of water makes him breathless.)

Here are the classes and a few lame mnemonics.

NYHA Class I: Cardiac disease, but no symptoms and no limitation in ordinary physical activity, e.g. no shortness of breath when walking, climbing stairs etc.
Mnemonic: ONe - NO limitation in activity.

NYHA Class II: Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity.
Mnemonic: Two, symptoms when he flew (Symptoms when he walked / climbed stairs)

NYHA Class III: Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20–100 m).
Mnemonic: Three, can't be ordinary. (Symptoms on less than ordinary activity like combing hair)

NYHA Class IV: Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients.
Mnemonic: "Forest" Four - Symptoms at Rest
Always on fours (In bed or on chair)

That's all!

-IkaN

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