Congestive Heart failure treatment

New York Heart Association Functional Classification
I: Heart disease present but no eveidence of heart failure or exercise intolerance; cardiomegaly minimal to absent
II: Signs of heart disease with evidence of exercise intolerance; radiographic cardiomegaly present
III: Signs of heart failure with normal activity or at night (e.g. cough, orthopnea); radiographic signs of significant cardiomegaly and pulmonary edema or pleural/abdominal effusion
IV: Severe heart failure with clinical signs at rest or with minimal activity; marked radiographic signs of congestive heart failure (CHF) and cardiomegaly

Forrester’s Classification (Group)
I: Normal cardiac output and pulmonary venous pressures
II: Pulmonary congestion but normal cardiac output
III: Low cardiac output and peripheral hypoperfusion with no pulmonary congestion
IV: Low cardiac output with pulmonary congestion

Most current treatment strategies for heart failure are aimed at modifying either the results of neurohormonal activation (e.g. sodium and water retention) or the activation process itself (e.g. angiotensin-converting enzyme inhibition). In most cases, therapy centers on controlling edema and effusions, improving cardiac output, reducing cardiac workload, supporting myocardial function, and managing concurrent arrhytmias. The approach of these goals varies somewhat with different diseases, most notably those causing restrictions to ventricular filling.

The clinical severity of heart failure is sometimes described according to a modified New York Heart Association classification scheme. This system groups patients into four functional classes based on subjective evaluation of the clinical condition, without consideration of etiology or myocardial function. This classification can be helpful conceptually and for categorizing study patients. However, to best individualize therapy, it is important to determine the etiology as well as the severity of heart failure. Forrester’s classification is another method of grouping heart failure patients. Dogs with chronic mitral regurgitation often fall into group II; severe dilated cardiomyopathy is the most common diagnosis in group IV. Diseases that cause group III characteristics are rare in dogs and cats. Regardless of the clinical classification scheme, identification of the underlying disease and pathophysiology is important for guiding therapy.

We would love to hear your pet's story. Please add a comment.