Grade l - Patient suffering from organic heart disease is able to carry out normal active life without discomfort.
Grade ll - Patient with organic heart disease experiences discomfort (breathlessness, exhaustion) on ordinary physical activitities.
Grade lll – Patient with organic heart disease experiences discomfort even after minimal activities.
Grade lV - Patient with organic heart disease is unable to carry out any physical activity without breathlessness. She may be breathless even at rest.
The classification is based on subjective symptoms and does not relate to the degree of cardiac lesion. Grading is made at the time of examination of the patient. There is a possibility of change over of a patient from one grade to another during pregnancy. This functional assessment of the patient is made on her history of daily routine work, and therefrom her ability to go through the strains of pregnancy and labor can be assessed in anticipation. However in assessment, objective signs are also carefully elicited.
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