NYHA class IV Pulmonary arterial hypertension


What is NYHA Class IV Pulmonary Arterial Hypertension?

Pulmonary arterial hypertension (PAH) is a cardiopulmonary disorder that results in an increased pressure in the pulmonary artery system. This increased pressure can lead to significant symptoms and even death. The New York Heart Association (NYHA) created a classification system to help determine the severity of pulmonary arterial hypertension.

Class IV: NYHA Dyspnea

NYHA class IV is the most severe level of pulmonary arterial hypertension. Patients with class IV PAH will experience severe shortness of breath while at rest. This shortness of breath is typically marked and may even be accompanied by symptoms of chest pain, fainting, or dizziness. Those with this type of PAH experience a decreased activity tolerance and may even be confined to bedrest.

Symptoms of Class IV PAH

Patients with class IV PAH may also experience other symptoms, such as:

  • Difficulty breathing even when resting
  • Tiredness and fatigue
  • Weight loss
  • Ankle, abdominal or facial swelling
  • Bluish color around the lips
  • Rapid heartbeat
  • A decrease in appetite
  • Low blood pressure

Diagnosis and Treatment

Patients with class IV PAH will need to obtain a thorough medical and lifestyle evaluation. This evaluation will help determine other possible causes of symptoms such as a heart condition, clotting disorders, or other diseases. Additional testing such as echocardiography, pulmonary function tests, blood tests, chest x-ray, and CT scan may be needed to make an accurate diagnosis. Treatment will vary depending on age, current medications, and other medical conditions.

Class IV pulmonary arterial hypertension is a serious condition that requires medical treatment. The goal of treatment is to reduce symptoms, reduce the risk of complications, and hopefully extend lifespan. Medications, lifestyle changes, and oxygen supplementation are effective strategies to manage the symptoms and progression of the disease.