Cardiology Question 18 Instructor

What is the Killip classification for acute myocardial infarction and the associated in-hospital mortality?

Class Physical Findings Mortality
I No heart failure 6%
II Mild heart failure: rales at bases, S3 gallop, or venous hypertension 17%
III Heart failure: Frank pulmonary edema 38%
IV Cardiogenic shock 81%

Based on a series of New York patients with acute myocardial infarction reported in one of the first CCU in North America. Over the years the mortality of patients have improved but the mortality of class IV patients remains high. This classification remains useful today as it is simple and based primarily on physical examination and still provides useful information for triaging patients.

Killip T, Kimball JT. Treatment of myocardial infarction in a coronary care unit: a two year experience with 250 patients. Am J Cardiol 1967; 20:457-64

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