Heart Failure Stages

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Topic Overview

The American College of Cardiology and the American Heart Association have devised a classification system for heart failure. It categorizes heart failure based on how the disease progresses in most people. Under this system, heart failure is classified by stages A through D.footnote 1

Stages of heart failure





Person is at high risk for developing heart failure. But there is no structural disorder of the heart.

Person has high blood pressure, coronary artery disease, diabetes, a history of drug or alcohol abuse, a personal history of rheumatic fever, or a family history of cardiomyopathy.


Person has a structural disorder of the heart. But the person has never had symptoms of heart failure.

Person has structural changes to the left ventricle, has heart valve disease, or has had a heart attack.


Person has past or current symptoms of heart failure. Symptoms are linked with underlying structural heart disease.

Person has shortness of breath or fatigue caused by left ventricular systolic dysfunction. Or the person does not have symptoms and is getting treatment for prior symptoms of heart failure.


Person has end-stage disease. He or she needs specialized treatment strategies.

Person is often hospitalized for heart failure or cannot be safely discharged from the hospital. Or the person is in the hospital waiting for a heart transplant. Or the person is at home getting continuous intravenous support for symptom relief or being supported with a mechanical circulatory assistive device. Or the person is in a hospice setting for the management of heart failure.



  1. Yancy CW, et al. (2013). 2013 ACCF/AHA Guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 62(16): e147–e239.


ByHealthwise Staff
Primary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical ReviewerStephen Fort, MD, MRCP, FRCPC - Interventional Cardiology

Current as ofFebruary 20, 2015