Cardiology Question 6 Instructor

What is the hemodynamic (Forrester) classification in acute myocardial infarction?

In 1977, Forrester et al. proposed the use of right heart catheterization (RHC) in acute myocardial infarction AMI and classified patients into four invasive subsets based on cardiac index (CI) and pulmonary artery wedge pressure (PWP) values.

Threshold values for PWP and CI were 18 mm Hg and 2.2 L/min/m, heralding imminent pulmonary edema and cardiogenic shock, respectively. It predicted the in-hospital mortality independently of the patient’s age, gender, precipitating factors, and AMI location.

Forrester J, Diamond G, Chatterjee K, et al. Medical therapy of acute myocardial infarction by application of hemodynamic subsets (first of two parts). N Engl J Med. 1976; 296:1356-1362.

Siniorakis E, Arvanitakis S, Voyatzopoulos G, et al. Hemodynamic Classification in Acute Myocardial Infarction. Chest 2000; 117; 1286-1290.

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