Heart Failure for UPSC CMS: NYHA Classification, Management and the 2022 ESC Guidelines

NYHA Classification#

Class I: No limitation. Ordinary activity causes no symptoms.
Class II: Slight limitation. Comfortable at rest, ordinary activity causes fatigue.
Class III: Marked limitation. Less than ordinary activity causes symptoms.
Class IV: Unable to carry out any activity without discomfort. Symptoms at rest.

HFrEF Management (2022 ESC)#

Four pillars:

1. ARNI (sacubitril/valsartan) or ACE-I/ARB
2. Beta-blocker (bisoprolol, carvedilol, metoprolol succinate)
3. MRA (spironolactone, eplerenone)
4. SGLT2 inhibitor (dapagliflozin, empagliflozin)

Add: Diuretics (symptom relief), Ivabradine (if HR >70 on max beta-blocker).