Rosh Internal Medicine Boost Practice Exam

In which New York Heart Association (NYHA) classification category does a patient with difficulty breathing when walking around, but not at rest, fall?

1. NYHA class I

2. NYHA class II

3. NYHA class III

4. NYHA class IV

The correct answer is: NYHA class III

A patient who experiences difficulty breathing when walking around but is comfortable at rest would be categorized in the NYHA class II classification. In this classification system, NYHA class II is defined by mild heart failure where patients have slight limitation of physical activity. They are comfortable at rest, but ordinary physical activity can lead to fatigue, palpitations, or dyspnea (shortness of breath). NYHA class I describes patients with no limitations; they can perform ordinary activities without any symptoms. Class III represents more significant functional impairment where patients experience symptoms with minimal exertion, such as walking a short distance. Finally, class IV is the most advanced stage, where patients are unable to carry on any physical activity without discomfort, and symptoms may be present even at rest. Thus, the description matches NYHA class II, indicating the need to assess the patient’s functional status further and consider appropriate management strategies.