Cardiology

ACC/AHA Heart Failure Staging

Classifies heart failure progression into stages A–D to guide therapy and prognosis.

Score interpretation

Stage A — At Risk 1

High risk for HF (HTN, DM, obesity, family history) but no structural disease or symptoms.

→ Risk factor modification: treat HTN, DM, obesity. Avoid cardiotoxins. ACEi/ARB if indicated.

Stage B — Pre-Heart Failure 2

Structural heart disease (prior MI, reduced EF, LVH, valve disease) but no HF symptoms.

→ All Stage A measures + ACEi/ARB, beta-blocker for post-MI. ICD if EF ≤30% on optimal therapy.

Stage C — Symptomatic HF 3

Known structural heart disease with current or prior HF symptoms (dyspnoea, fatigue, reduced exercise).

→ GDMT: ACEi/ARB/ARNI + beta-blocker + MRA + SGLT2i. Device therapy if indicated.

Stage D — Advanced / Refractory HF 4

Refractory symptoms at rest despite maximal GDMT. Recurrent hospitalisations.

→ Advanced therapies: cardiac transplantation, LVAD, inotropes, palliative care.

Interpretation bands for the ACC/AHA HF Stage. Apply clinical judgement and local guidance.

Heidenreich PA et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. J Am Coll Cardiol. 2022;79(17):e263-e421.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.