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ACC/AHA Heart Failure Staging

CardiologyHeart failureStagingBeta toolThis tool is in beta. It has undergone internal validation but still requires additional testing. Always confirm the data entered and the results obtained before clinical use. It should not be used as the sole basis for clinical decisions.
Advanced/refractory heart failure presentSelect yes when advanced or refractory heart failure is present. This has highest precedence and assigns Stage D.
Current or prior symptoms/signs attributable to heart failureSelect yes for current or prior symptoms/signs attributable to heart failure. Prior symptomatic heart failure remains at least Stage C even if the patient is currently asymptomatic.
No symptoms/signs, but evidence of structural heart disease or other stage B/pre-HF findingsSelect yes when stage B/pre-HF evidence is present without current or prior HF symptoms/signs. Interpret biomarker, imaging, and hemodynamic findings in the full clinical assessment.
Risk factors/exposures for heart failure present without qualifying stage B/C/D findingsSelect yes only when there are heart-failure risk factors or exposures without qualifying Stage B, C, or D findings.
Use completed years. This classification is intended for adults; use appropriate pediatric assessment for people younger than 18 years.
years

Clinical noticeEducational staging support only. Interpret alongside clinical assessment, diagnostic workup, and NYHA classification when appropriate.

Context and use

If age < 18 years => out of scope. Otherwise, D > C > B > A by the first applicable affirmed category.

D if advanced HF; C if current or prior HF symptoms/signs; B if pre-HF evidence without symptoms; A if risk factors only.

Identifying pre-HF requires clinical judgment; interpret biomarker, imaging, and hemodynamic findings in the full clinical context.

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