A patient with heart failure who experiences dyspnea on exertion and requires 3 pillows to sleep at night is classified in which NYHA HF stage?

The New York Heart Association (NYHA) classification system is a widely used method to assess the functional limitations of patients with heart failure based on their symptoms during physical activity.

In this case, the patient experiences dyspnea on exertion, indicating that physical activity is limited and uncomfortable. The requirement of three pillows to sleep at night is indicative of orthopnea, a condition where the patient has difficulty breathing when lying flat and must elevate the head to be comfortable. This reflects more significant heart failure symptoms.

Stage III in the NYHA classification is characterized by patients who experience marked limitation of physical activity. They are comfortable at rest, but less than ordinary activity, such as walking or climbing stairs, leads to excessive fatigue, palpitations, dyspnea, or anginal pain. The description of requiring three pillows to sleep shows that the patient has a moderate to severe level of heart failure, which aligns with Stage III, as resting does not alleviate the discomfort associated with activity levels leading to dyspnea.

Therefore, the classification of this patient as Stage III is fitting, as their symptoms indicate a clear limitation on their physical activity due to heart failure while still being able to rest comfortably.