One of the vital organs in the body is the heart. It must always be taken care of. Doctors detect various diseases in the early stages, thanks to modern research methods. But it depends on the person himself how timely he will pay attention to deviations in his he alth. In adulthood or old age, regular examinations are necessary. Very quickly, heart failure can go into a chronic stage, which in advanced cases is difficult to treat and poses a great threat to human life. Consider what are the functional classes of CHF next.
What does CHF mean
Chronic heart failure is characterized by such a condition of the main organ, in which it is not able to pump blood in the required volume due to pathological changes. As a result, there is insufficient blood supply to tissues and organs as a whole. All body systems suffer.
The disease can be recognized at the first stage, if not ignoredfirst symptoms. In this case, the treatment will be successful, since the changes that have occurred in the body are still easily reversible. In advanced stages, this pathology can lead to death, to sudden death.
CHF has a classification according to functional classes.
Why CHF occurs
The development of chronic heart failure can occur for a number of reasons:
1. There are diseases that affect the myocardium:
Chronic ischemia
The consequences of a heart attack.
2. Heart disease:
- Birth defects and acquired.
- Arrhythmia.
- Blockades.
- Inflammatory heart disease.
3. Endocrine Diseases:
- Diabetes mellitus.
- Impaired thyroid function.
- Disorders of the adrenal glands.
4. Wrong lifestyle:
- Overweight.
- Lack of vitamins and minerals in the diet.
- Depletion of the body.
- Insufficient physical activity.
- Bad habits.
5. High blood pressure.
6. Chronic renal failure.
7. HIV infection.
8. Metabolic disorder.
9. Diseases that are accompanied by deposition in the tissues of structures unusual for them:
- Sarcoidosis.
- Amyloidosis.
Symptoms of heart failure can be severe or subtle. In the first stages theyless pronounced. Knowing how the disease is classified is important for recognition.
Degrees of disease
It is possible to distinguish degrees and functional classes during the development of CHF.
Let's consider what degrees are:
- Easy. It is very difficult to recognize, as the symptoms are associated with general fatigue or bad weather, but this stage is compensated. All processes can be restored.
- Moderate degree. It is divided in this way: 2a - insufficiency in the pulmonary circulation, 2b - circulatory failure affected the entire vascular system. It is very difficult to restore damaged tissues and organs.
- Severe degree. All pathological changes cannot be restored. In this case, it remains to carry out activities that support the body to prolong life.
It is worth noting that the transition from one degree to another without the necessary treatment takes only 1-2 years.
CHF classification
In 1965, American cardiologists developed a classification that differs from the Soviet one. She gives an assessment based on the severity of the patient's condition. This does not take into account violations in the systemic and pulmonary circulation.
The functional classes of CHF according to NYHA are as follows:
- The disease appears slightly. At rest, there are no symptoms. With significant physical exertion, severe fatigue is not noticed.
- At rest, no pathological changes are observed. Physical activity causes fatigue and shortness of breath.
- At rest, does not feel discomfort, but with the slightest load, heart palpitations, shortness of breath appear.
- Pathological changes in tissues and organs are irreversible. Symptoms are pronounced at rest.
This classification is not suitable to objectively assess the severity of right ventricular failure of decompensated cor pulmonale. But it is simple and often used in clinical practice.
It is worth noting that degrees 2 and 3 correspond to 2a and 2b according to the definition of CHF functional classes according to Strazhesko-Vasilenko. More on that later.
Classification according to Strazhesko-Vasilenko
Russian cardiologists use this technique as the basis for determining the severity of CHF.
We will provide functional classes of CHF according to Strazhesko-Vasilenko with additions by N. M. Mukharlyamov and L. I. Olbinskaya.
1. Changes in the body are not detected at rest. Only during exercise can deviations from the norm be detected.
- Stage 1a. Preclinical. There are no complaints. Under exercise, a decrease in myocardial contractility and an increase in the end-diastolic volume of the left ventricle can be detected.
- Stage 1b. Hidden chronic. Symptoms only appear during exercise. At rest, all systems normalize their work.
2. The movement of blood through the vessels is impaired. There is stagnation in the circles of blood circulation and at rest.
- Stage 2a. Symptoms are moderately expressed at rest. Blood circulation is disturbed in one of the departmentscardiovascular system, in a small or large circle.
- Stage 2b. The final stage in the development of chronic heart failure. There are circulatory disorders in the vessels of the entire cardiovascular system.
3. Violations of the movement of blood through the vessels and venous congestion in both circles of blood circulation are pronounced. Pathological changes in the functioning of organs and tissues.
- Stage 3a. Severe symptoms of blood stasis in both circulations.
- Stage 3b. Severe circulatory disorders that led to irreversible changes in tissue structures and organ function.
Both classification systems complement each other. Specialists indicate the stage according to N. D. Strazhesko and V. Kh. Vasilenko, and next to it is information about functional classes according to NYHA.
Symptomatics of CHF 1 and 2 degrees
Let's list the symptoms characteristic of the first degree of CHF:
- Fatigue sets in earlier than usual.
- After significant exertion, the heart rate increases more than usual.
- Bad dream.
- Shortness of breath may occur after prolonged conversation or after exercise.
The symptoms of grade 2a are characterized by the following manifestations:
- Shortness of breath occurs after little exercise.
- Worried about the feeling of heaviness in the right hypochondrium.
- With minor physical exertion, the heart rate increases significantly.
- Insomnia appears.
- Appetite worsens.
Grade 2b symptoms:
- Painfulfeeling in the chest area.
- Dyspnea may occur at rest.
- Increased resting heart rate.
This stage is much more difficult to treat. It is not always possible to restore all the lost functions of tissues and organs.
Symptoms of grade 3 CHF
This is a very difficult situation and poses a serious threat to the life of the patient.
Symptoms for CHF 3 functional class are as follows:
- Arrhythmia.
- The bluish tint of not only the skin, but also the mucous membranes.
- Puffiness of the whole body.
- Cough accompanied by hemoptysis.
- Dyspnea is very common.
- Moist rales in the lungs.
- Heartbeat is weak and rapid.
Application of CHF classification
As a rule, the simplest methods are most often used to make a diagnosis. So, to determine the functional class of CHF in the USA and in our country, a very simple method is used.
In America, there is a Cooper test. It consists in the following: the patient walks a certain distance along the corridor for 6 minutes, according to which the stage of CHF can be assessed. The interpretation of the results is:
- If the patient walked 425-550 meters, this is an easy stage of CHF.
- Distance 150-425 meters - indicates the middle stage, the tension of compensatory reactions.
- Distance less than 150 meters overcome with severe heartinsufficiency. This is the stage when the body is not able to compensate for the damage caused by CHF.
In Russia, the cardiology department is often located on the upper floors of the clinic. So you can evaluate the blood circulation in CHF. The classification of functional classes by floors is as follows:
- The appearance of shortness of breath when climbing the first flight of stairs belongs to the third functional class.
- When going up to the first floor, the appearance of shortness of breath indicates the second functional class.
- If you managed to overcome 3 floors without shortness of breath - the third functional class.
- If shortness of breath is observed at rest, then these are signs of patients with decompensation, which belong to the fourth functional class.
Determination of CHF classification of functional classes according to NYHA is of great importance in the therapeutic treatment of patients.
CHF in animals
Chronic heart failure can affect not only humans, but also animals. It is possible to distinguish the stages and functional classes characteristic of CHF in dogs. This disease is typical for age four-legged pets of small and large breeds. In cats, the disease is almost never found.
Depending on the degree of development of CHF in a dog, functional classes will look like this:
- 1 class. Symptoms are not expressed. You may notice deviations with strong physical or emotional stress.
- 2 class. At rest, symptoms are not observed. Atmoderate exercise may cause symptoms.
- 3 class. At rest, symptoms are not expressed. With a moderate load, signs of CHF appear.
- 4 class. The symptoms are pronounced at rest. Symptoms worsen with any physical activity.
What can cause the development of CHF in a dog, we will consider further.
Causes of CHF in animals
Dogs can develop CHF for the following reasons:
- Excessive exercise.
- Overwork.
- Overload of the heart muscle.
- Obesity.
- Diseases of the kidneys and liver.
- Bronchopulmonary pathologies.
- Arterial hypertension.
- Myocarditis.
- Defects of the heart.
- Toxins.
ChF stages in dogs
Consider the symptoms of CHF stages:
- 1 stage. Symptoms do not appear. On examination, you can find that the MC is changed, while the atrium is not enlarged.
- 2 stage. Symptoms are not noticeable. The atrium and ventricle have minor changes.
- 3 stage. There is a symptom in the form of cough, shortness of breath. Moderate congestion can be found in the lungs. Increased pressure in the left atrium.
- 4 stage. The heart is not pumping well. Enlarged liver. Increased risk of pulmonary edema.
Diagnosis and prevention of CHF in animals
To make a diagnosis of CHF in a dog, a number of tests are needed:
1. Clinical. Identification of obvious symptoms. such as shortness of breath, lethargy,peripheral edema and so on.
2. Instrumental:
- ECG.
- Ultrasound.
- Chest X-ray.
3. Lab:
- General analysis of urine and blood.
- Presence of sodium, potassium, creatinine.
CHF prevention is one of the most important activities for older dogs. Required once a year:
- examination at the vet;
- take blood and urine tests;
- Ultrasound of the heart;
- electrocardiography.
If the pathology is detected at an early stage, then this is a great chance to cure the disease and prolong the life of your pet.
Significance of CHF classification
Determining the stage of CHF and functional class is of great importance when prescribing therapeutic treatment. The NYHA score is based on the patient's condition and is widely used in prescribing therapy. The classification according to Strozhenko-Vasilenko describes in more detail the picture of the development of heart failure.
Determination of the functional class makes it possible not only to select the treatment, but also to predict its results. Also important is the selection of diet, physical activity.
Forecasts for functional classes in CHF are as follows:
- 1 FC die 10% annually.
- 2 FC - about 20% with CHF.
- 3 FC – approximately 40%.
- 4 FC - 65% of patients die per year.
ChF prevention
It should be noted preventive measures that will help avoid the development of CHF:
- Normalizationsupply.
- Regular physical activity.
- Rejection of bad habits.
- Prevent obesity.
- Treatment of chronic heart disease.
It is necessary to regularly undergo preventive examinations with a therapist. If unusual symptoms appear, you should consult a doctor in a timely manner, as pathological processes can become irreversible in 1-2 years.
