[Verified Answer]: Q.E., a 57-year-old white woman with a…

Q.E., a 57-year-old white woman with a medical history significant for breast cancer, completed a 6-cycle regimen of chemotherapy including doxorubicin, docetaxel, and cyclophosphamide less than 1 week ago. She feels fatigued, which her oncologist attributes to the recent chemotherapy. Out of an abundance of caution, Q.E. is referred to a cardiologist who performs a laboratory assessment and ECHO that resulted in an NT-proBNP of 390 pg/mL [reference range <125 pg/mL] and a left ventricular ejection fraction (LVEF) of 58% and no identifiable abnormalities. Q.E. denies any symptoms of heart failure (HF) and reports being able to complete her normal activities of daily life without limitations. During her annual follow up visit to the cardiologist QE had a repeat ECHO and laboratory assessment that reported a LVEF of 38% and NT-proBNP of 1670 pg/mL [reference range < 125 pg/mL]. Over the past month, she reports being unable to walk up a flight of stairs without assistance, frequent breaks due dyspnea while brushing her teeth or collecting the mail, and requiring2-3 pillows propped in a chair to sleep a few times per week. Which one of the following best categorizes QE according to the HFSA/HFA-ESC/JHFS staging system and NYHA functional classification? HF and NYHA Class II HF and NYHA Class III Advanced HF and NYHA Class III Advanced HF and NYHA Class IV