The New York Heart Association Functional Classification or NHYA for short, is a simple way for your doctor or nurse to classify your heart failure. It is based on your physical ability to do things, as well as other potential symptoms like your breathing and shortness of breath. It is a great way to see how well you are doing, as the measurements are mainly based on observation.

The reason why the NYHA scale is important to you is two fold.

  1. It allows you to understand how your symptoms affect your quality of life thus giving you awareness of what you maybe able to do to affect them
  2. The NYHA scale is used by regulatory bodies like the National Institute of Health and Care Excellence (NICE) and SIGN in Scotland. You may be wondering why this is important to you, please read on. NICE develops pathways. Pathways are an agreed best way of doing things. So the best and most up to date way of managing long term chronic heart failure can be found here on the NICE Chronic Heart Failure Guidance web page. To get further information on treatment and care please read our Patient Charter, developed by patients like you living with heart failure

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Remember the more knowledge you have about your condition the better you get at managing it.

  • NYHA I – No limitation of physical activity. Ordinary physical activity does not cause undue tiredness, palpitations, or shortness of breath.
  • NYHA II – Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in tiredness, palpitations, or shortness of breath.
  • NYHA III – You are comfortable at rest, but less than ordinary activity causes tiredness, palpitations, or shortness of breath.
  • NYHA IV – You are unable to carry out any physical activity without discomfort and are tired and short of breath even at rest. If any physical activity is undertaken, discomfort is increased.


In our experience people living with heart failure really focus too much sometimes on the numbers sometimes, let your doctors and nurses relate the relevance of these numbers. Observation plays a big part in heart failure management by doctors and nurses, therefore observe yourself. If you are newly diagnosed you could be at NYHA 4 and then in 12 months with the right management be at NYHA 1. You may have well managed heart failure symptoms where you float between NYHA 2 and NYHA 3 so you will probably know when you are in 3 rather than 2.  Heart failure is the type of condition that can be great 4 days of the week and difficult 3 days of the week.

Secret sauce

Dictionary – “A special quality or feature regarded as the chief factor in the success of something or someone.”

So, what’s your “Secret Sauce?” What makes you tick?

At Pumping Marvellous, we know it takes some real inner drive to live well with heart failure. Pumping Marvellous are Secret Sauce catalysts; we draw out people’s inner Secret Sauce, people’s superpowers and enable other people to learn from other people’s experiences.

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About us

Who, What, Why?

We are the Pumping Marvellous Foundation, the UK’s heart failure patient-led charity. Find out more about why we do what we do.
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Get involved

The Pumping Marvellous Foundation are a UK patient led heart failure charity. To find out how you can get involved click below.
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The Pumping Marvellous charity shop is full of our own branded merchandise. By purchasing our merchandise, you will help us fund our projects.
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