Classification of heart failure

Acute and chronic heart failure may be left ventricular and right ventricular, however, both ventricles often develop simultaneously, i.e. Total heart failure. Currently in our country two classifications are used in assessing heart failure in adults.

Classification of N.D. Strazhesko and V.Kh. Vasilenko assumes the following stages.

• I stage - latent heart failure, detected only with physical exertion.
• Stage II - marked prolonged heart failure (stagnation in a small and / or a large circle), the symptoms are expressed in rest:
  • II A - violations of hemodynamics are poorly expressed, in one of the divisions (in a large or small circle of circulation):
  • II B - deep violations of hemodynamics - the end of the long stage, the involvement of large and small circles of circulation:
• III stage, the final - dystrophic changes in organs with severe hemodynamic disorders, persistent changes in metabolism and irreversible changes in the structure of organs and tissues.

Functional classes of the New York Heart Association are as follows.

• I class - patients with heart diseases, but without the limitations of physical activity, normal physical activity does not cause inadequate fatigue, palpitations, dyspnea or angina pectoris.
• II class - the activity is moderately limited in connection with the appearance of dyspnea, palpitation, fatigue during normal daily exercise. At rest, patients feel well.
• III class - a significant limitation of physical abilities. The appearance of symptoms of heart failure or angina at a load below everyday.
• IV class - patients are not capable of any physical activity without a feeling of discomfort. Symptoms of heart failure or angina may occur in them alone.

The presented classifications do not contain nuances that characterize blood circulation in children: centralization of blood circulation and extreme lability of blood circulation, which is especially pronounced in young children. Especially this applies to the New York classification, based more on the subjective feelings of the patient. In the United States, a methodology for determining functional classes over a distance of 6 minutes' walk has been developed. The condition of patients able to overcome from 426 to 550 m within 6 minutes corresponds to mild chronic heart failure, from 150 to 425 m - medium, and those who are unable to overcome and 150 m - severe decompensation.

Therefore, we consider it appropriate to use the classification proposed in 1979 to assess heart failure in children. Belokon as a worker. This classification suggests clinical variants of heart failure in the left ventricular and right ventricular type.

Signs and degree of heart failure in children

Power	Failure
	Left ventricular	Right ventricular
I	Signs of heart failure at rest are absent and appear after a load in the form of tachycardia or dyspnea
IIA	The heart rate and the number of respiratory movements per minute are increased by 15-30 and 30-50%, respectively, relative to the norm	The liver protrudes 2-3 cm from under the edge arch
II B	The heart rate and the number of respiratory movements per minute are increased by 30-50 and 50-70%, respectively, relative to the norm; Possible: acrocyanosis, obsessive cough, wet small bubbling rales in the lungs	The liver protrudes 3-5 cm from under the rib arc, the swelling of the cervical veins
III	The heart rate and the number of respiratory movements per minute are increased by 50-60 and 70-100% or more, respectively, relative to the norm: the clinical picture of the pre-infection and pulmonary edema	Hepatomegaly, edematous syndrome (swelling on the face, legs, hydrothorax, hydropericardium, ascites)

[1], [2], [3], [4], [5], [6], [7]