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Chapter 25 – Heart Failure (QE) Sample Questions

1. PK, a 66-year-old man reports to his family physician shortness of breath (SOB) when walking up 1 flight of stairs or when dressing up that has made difficult to do by himself. PK also complains of SOB on exertion with persistent cough. He says his symptoms have worsened in the past few weeks. He has no chest pain or neurological problems. His lab reports show high B-type natriuretic peptide level of 210 pg/dL (normal <120) and blood pressure is currently at 135/90.With PK’s symptoms, which of the New York Heart Association (NYHA) classifications would describe PK’s condition?

A. NYHA Class I
B. NYHA Class II
C. NYHA Class III
D. NYHA Class IV

Answer

Ans: C

NYHA Class 1 = No symptoms with ordinary activity which include walking, climibing stairs,
NYHA Class 2 = Slight limitation of ordinary activity walking of climbing stairs rapidly, walking uphill, walking or stair climbing after meals, in cold, in wind, or when under emotional stress or walking more than 2 blocks or climbing 1-stairs.
NYHA Class 3: marked limitation of ordinary activity walking 1 or 2 blocks on the level, or climbing 1 flight stairs.
According to NYHA ordinary activities of daily living, such as walking, climbing stairs or light household tasks, that do not cause excessive fatigue, or shortness of breath, or other symptoms. It is typically associated with class II on the NYHA scale.

Less than ordinary activity typically refers to class III which means individual experience noticeable limitation in their physical activity. This means that activities like walking short distances or performing routine task may cause fatigue, shortness of breath.
https://www.merckmanuals.com/en-ca/professional/multimedia/table/new-york-heart-association-nyha-classification-of-heart-failure

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