Which Stage of Heart Failure Am I In?

A fellow caregiver asked...

How can you determine what stage of heart failure you are in and since you can improve, why have stages?

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

The stages of heart failure are determined by how much shortness of breath you have, related to the amount of activity you can do without symptoms.  For instance, some people can completely take care of themselves, such as dressing or bathing, with minimal shortness of breath.  This would be Stage 1.  Or, you may be short of breath with all activity, but at rest you are comfortable, which is considered Stage 3.  Stage 4, the most severe, is when you have symptoms even at rest.

We have a rating system for heart failure because as heart failure progresses, this allows the medical team to form treatment plans related to the symptoms a patient is having.  As the disease progresses, symptoms worsen, so the goals of care are going to be different along the way.   

It is true that some patients improve with medications and surgical treatment.  However, not every patient has these options available to them.  Sometimes, advanced age can limit treatment options, as can other diseases that a person may have.  Every patient is different, so the goals of care must be tailored to an individual's needs.