{"id":53217,"date":"2022-02-22T19:57:06","date_gmt":"2022-02-22T14:27:06","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=53217"},"modified":"2022-02-22T20:51:21","modified_gmt":"2022-02-22T15:21:21","slug":"ross-heart-failure-classification-for-infants-and-children","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/ross-heart-failure-classification-for-infants-and-children\/","title":{"rendered":"Ross heart failure classification for infants and children"},"content":{"rendered":"<p><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/tXWeDfljB4M\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Ross heart failure classification for infants and children<\/span><\/h2>\n<p>All of us are familiar with the New York Heart Association (NYHA) functional classification. But it is not applicable to most of the pediatric population. Ross RD et al tried to determine which variables most accurately define congestive heart failure in infants [1]. Forty one patients with median age of 2.5 months were graded by four pediatric cardiologists for the presence and severity of congestive heart failure based on several parameters. The parameters evaluated were amount of formula consumed per feeding, feeding time, history of diaphoresis or tachypnea, growth parameters, respiratory and heart rates, respiratory pattern, perfusion, presence of edema, diastolic filling sounds, and hepatomegaly. In that study, 19 patients were graded as having no congestive heart failure, nine as mild, seven as moderate and six as severe congestive heart failure. This seminal work led to the Ross classification for heart failure in infants. Later the classification was modified to include all children.<\/p>\n<p>The modified Ross heart failure classification for children is widely cited and is as follows [2]:<\/p>\n<p>Class I: Asymptomatic<\/p>\n<p>Class II: Mild tachypnea or diaphoresis with feeding in infants; Dyspnea on exertion in older children<\/p>\n<p>Class III: Marked tachypnea or diaphoresis with feeding in infants and prolonged feeding times with growth failure; marked dyspnea on exertion in older children<\/p>\n<p>Class IV: Tachypnea, retractions, grunting or diaphoresis at rest.<\/p>\n<p>In general, it can be seen that it corresponds to the NYHA functional classification with addition of features specific for infants.<\/p>\n<p>In 2012, Ross RD reviewed the classification and suggested an age-stratified scoring system [3]. In that article, it was mentioned that several modifications for the initial system have been used and others proposed. Grading of signs and symptoms in children is dependent on age because infants manifest heart failure differently than toddlers and older children. It was also noted that in addition to signs and symptoms, data from echocardiography, exercise testing and biomarkers like N-terminal pro-brain natriuretic peptide (NT-proBNP) are useful in stratifying outcomes in children with heart failure.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li>Ross RD, Bollinger RO, Pinsky WW. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/1614922\/\">Grading the severity of congestive heart failure in infants<\/a>. Pediatr Cardiol. 1992 Apr;13(2):72-5. doi: 10.1007\/BF00798207. PMID: 1614922.<\/li>\n<li>Hsu DT, Pearson GD. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19808316\/\">Heart failure in children: part I: history, etiology, and pathophysiology<\/a>. Circ Heart Fail. 2009 Jan;2(1):63-70. doi: 10.1161\/CIRCHEARTFAILURE.108.820217. PMID: 19808316.<\/li>\n<li>Ross RD. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22476605\/\">The Ross classification for heart failure in children after 25 years: a review and an age-stratified revision<\/a>. Pediatr Cardiol. 2012 Dec;33(8):1295-300. doi: 10.1007\/s00246-012-0306-8. Epub 2012 Apr 5. PMID: 22476605.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Ross heart failure classification for infants and children All of us are familiar with the New York Heart Association (NYHA) functional classification. But it is not applicable to most of the pediatric population. Ross RD et al tried to determine which variables most accurately define congestive heart failure in infants [1]. Forty one patients with [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":53220,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-53217","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Ross heart failure classification for infants and children - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/ross-heart-failure-classification-for-infants-and-children\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ross heart failure classification for infants and children - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Ross heart failure classification for infants and children All of us are familiar with the New York Heart Association (NYHA) functional classification. But it is not applicable to most of the pediatric population. Ross RD et al tried to determine which variables most accurately define congestive heart failure in infants [1]. Forty one patients with [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/ross-heart-failure-classification-for-infants-and-children\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2022-02-22T14:27:06+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-02-22T15:21:21+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2022\/02\/Ross-heart-failure-classification-for-infants-and-children.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1204\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ross-heart-failure-classification-for-infants-and-children\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ross-heart-failure-classification-for-infants-and-children\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Ross heart failure classification for infants and children\",\"datePublished\":\"2022-02-22T14:27:06+00:00\",\"dateModified\":\"2022-02-22T15:21:21+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ross-heart-failure-classification-for-infants-and-children\\\/\"},\"wordCount\":416,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ross-heart-failure-classification-for-infants-and-children\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wp-content\\\/uploads\\\/2022\\\/02\\\/Ross-heart-failure-classification-for-infants-and-children.jpg\",\"articleSection\":[\"General Cardiology\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ross-heart-failure-classification-for-infants-and-children\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ross-heart-failure-classification-for-infants-and-children\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ross-heart-failure-classification-for-infants-and-children\\\/\",\"name\":\"Ross heart failure classification for infants and children - 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