Review of the New York Heart Association (NYHA) Functional Classification for Heart Failure

The New York Heart Association (NYHA) Functional Classification is a clinician-assigned tool that categorizes patients with heart failure according to symptom burden and limitation with physical activity. It remains widely used in clinical practice, guidelines, and clinical trials to inform prognosis, guide management decisions, and standardize communication due to its simplicity, prognostic relevance, and role in considering patients for therapies. The scoring system marks functional limitations which are associated with heart failure hospitalizations and death. Although subjective and limited by interobserver variability, NYHA class provides a practical framework that should be interpreted alongside objective measures and patient-reported outcomes when assessing disease severity and planning care.