Random question about heart failure

[stephanie38]

I don't post often but have a question about something I noticed on my last two echos. There is a notation of NYHA Class I on them. There is no mention of heart failure in any of the findings or doctor notes. Is this just a blank that is filled in and everyone gets a 1? My history is a BAV, mild-mod mitral regurg and mild LVH. I'm in the process of finding a new cardio, so I can't really go back to him and ask. Any thoughts?

 

[Michelle D]

After my surgery I noticed in some records of an echo done five weeks later that it said something about congestive heart failure, I don't remember specifically what it said but I freaked out and called my cardio immediately, she said I do not have heart failure and not to worry about it. You should just give your cardiologist a call to clarify it for you.

 

[DebbyA]

Here are the NYHA definitions:
* Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities.
* Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.
* Class III: marked limitation of any activity; the patient is comfortable only at rest.
* Class IV: any physical activity brings on discomfort and symptoms occur at rest.

Class I looks pretty good. Maybe the doc thinks it's worth noting since you do have a condition. It's a question you could ask cardios you are considering, just to see how informative they are.

 

[Mentu]

Stephanie, this is a question you can ask your family doctor if you do not currently have a cardiologist. NYHA Class I indicates that your doctors should be monitoring your status but that you have no symptoms yet of CHF. You were probably automatically put into Class I because previous tests identified the "mild left ventricle hypertrophy". The hypertrophy is caused by the hearts attempt to compensate for the reduced size of the valve opening and with time it can leave the walls of the left ventricle stiff resulting in diastolic dysfunction. Diastolic dysfunction occurs when the left ventricle is unable to fill properly during the resting or "diastolic" beat because the stiffness of the walls prevents the ventricle from relaxing fully. When the ventricle cannot fill completely, blood flow from the heart is reduced. This puts one at risk of congestive heart failure. The report suggests that you are in little immediate danger.

Stephanie, we tend to focus on the state of the heart valve because that is the source of the problem. One of the arguments in favor of earlier intervention is this very issue of LVH which can place limits on how fully a person recovers after valve replacement. Fortunately, the heart is capable of significantly remodeling itself after surgery. In the best of circumstances, the hypertrophy and stiffness fade in the months of recovery. In other instances, such as my own, the process of remodeling can take several years. Like so many other things, no one can predict how completely the remodeling will proceed. If you remain in Stage I, it is likely that your heart will recover. Like you and I, most people with a bad valve probably have some degree of LVH. It is a concern and something to discuss with your cardiologist but not much can be done about it and there is little benefit in spending a lot of energy worrying over it.

Larry

 

[stephanie38]

Thanks for all the responses and the information. It's always comforting to hear the explanations of things and suggestions from all of you. Larry, I very much appreciate your explanation of LVH. My doctor turned out to be a real jack-wagon, but I knew even he would have told me if I actually had CHF. I am in search of a new cardio to continue monitoring everything. After reading so many posts, I have learned not to get to worried about anything! Thanks again.

 

[Greg a]

For the CANUKS

For the CANUKS

Here is our (Canadian) equivalent functions​

Canadian Cardiovascular Society Angina Grading ScaleThe Canadian Cardiovascular Society Angina Grading Scale is commonly used for the classification of severity of angina.[2]:
Class I – Angina only during strenuous or prolonged physical activity
Class II – Slight limitation, with angina only during vigorous physical activity
Class III – Symptoms with everyday living activities, i.e., moderate limitation
Class IV – Inability to perform any activity without angina or angina at rest, i.e., severe limitation

It is similar to the New York Heart Association Functional Classification of heart failure.