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20160425222516 Ben  
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NYHA Class I
    no symptoms
    no limitation: ordinary physical exercise does not cause undue fatigue, dyspnoea or palpitations

NYHA Class II
    mild symptoms
    slight limitation of physical activity: comfortable at rest but ordinary activity results in fatigue, palpitations or dyspnoea

NYHA Class III
    moderate symptoms
    marked limitation of physical activity: comfortable at rest but less than ordinary activity results in symptoms

NYHA Class IV
    severe symptoms
    unable to carry out any physical activity without discomfort: symptoms of heart failure are present even at rest with increased discomfort with any physical activity