July 22, 2022

Stages of heart failure, and how it’s treated

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These guidelines help ensure doctors are turning to the most up-to-date therapies.

To get the best care for heart failure, talk with your health care team. It is also helpful to know about a resource published by health experts that outlines treatment plans recommended for people with chronic heart failure. 

Since 1980, the American College of Cardiology and the American Heart Association have published guidelines to help health-care providers care for people who have heart failure or who are likely to have heart failure in the future. 

The guidelines are based on scientific research and medical evidence. 

The four stages of heart failure

Heart failure treatment guidelines are published for medical providers, using technical language. As a patient, you can take a more active role in your treatment if you ask questions about it and the guidelines behind it.  

The guidelines define four stages of heart failure:  

  • Stage A: At risk for heart failure. A person with certain risk factors for heart failure (for example, uncontrolled high blood pressure) but with no symptoms or imaging tests showing heart failure.   
  • Stage B: Pre-heart failure. Patients who show signs of heart problems based on imaging or blood work but who do not feel symptoms. An example: Someone who feels well but has heart imaging that shows mild weakness of the heart muscle.    
  • Stage C: Symptomatic heart failure, when someone develops heart failure symptoms, such as shortness of breath or fatigue.
  • Stage D: Advanced heart failurePeople with Stage D heart failure often have symptoms of shortness of breath or fatigue with minimal activities or even at rest. Sometimes they cannot tolerate medications because of low blood pressure. These patients may be hospitalized frequently. This is the most serious stage of heart failure.

For all stages of heart failure, the guidelines suggest specific treatments that your health-care provider will discuss with you.  

Take a proactive role

The guidelines apply to most people in most cases and outline a range of treatment choices.

Eventually, decisions about your medical care rest with you and your provider. Asking questions about your treatment is smart and responsible. It is your right to know your medical team’s goals for you and how clinical guidelines compare with your treatment plan. 

You are the most important member of your health care team. 

Middle-aged man sitting at a desk looking at his laptop screen in a sunny room.

Vanderbilt University Medical Center has one of the top heart failure programs in the nation with the expertise to care for all stages and causes of heart failure, from the most basic to the most complex. Vanderbilt’s innovative treatments offer hope when it’s needed most.

Download the treatment guide