New York Heart Association and modified Ross heart failure classification for children

	NYHA	Ross
Class I	No limitations of physical activity	No limitations or symptoms
Class II	May experience fatigue, palpitations, dyspnea, or angina during moderate exercise but not during rest	Infants – Mild tachypnea or diaphoresis with feeding Older children – Mild to moderate dyspnea on exertion
Class III	Symptoms with minimal exertion that interfere with normal daily activity	Infants – Growth failure and marked tachypnea or diaphoresis with feeding Older children – Marked dyspnea on exertion
Class IV	Unable to carry out any physical activity because they typically have symptoms of heart failure at rest that worsen with any exertion	Symptoms at rest such as tachypnea, retractions, grunting, or diaphoresis

NYHA: New York Heart Association.

Reproduced from: Kirk R, Dipchand AI, Rosenthal DN, et al. The International Society for Heart and Lung Transplantation Guidelines for the management of pediatric heart failure: Executive summary [Corrected]. J Heart Lung Transplant 2014; 33:888. Table used with the permission of Elsevier Inc. All rights reserved.

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New York Heart Association and modified Ross heart failure classification for children