Cardiology Emergency Medicine Critical Care A

Killip Classification for Acute MI

Classifies severity of acute myocardial infarction based on clinical features of heart failure. Predicts in-hospital mortality.

Score interpretation

Class I — No Heart Failure 1

No clinical HF. In-hospital mortality ~5%

→ Standard STEMI/NSTEMI management; reperfusion; dual antiplatelet; beta-blocker; ACEi

Class II — Mild Heart Failure 2

Mild HF. In-hospital mortality ~10%

→ IV diuresis; supplemental oxygen; consider early invasive strategy; monitor urine output and fluid balance

Class III — Pulmonary Oedema 3

Pulmonary oedema. In-hospital mortality ~20–40%

→ High-flow oxygen/NIV; IV frusemide; GTN infusion; urgent cardiology review; consider early PCI

Class IV — Cardiogenic Shock 4

Cardiogenic shock. In-hospital mortality ~85%

→ ICU; inotropes (dobutamine, noradrenaline); IABP or Impella; emergency PCI; consider ECMO; multidisciplinary shock team

Interpretation bands for the Killip Class. Apply clinical judgement and local guidance.

Killip T, Kimball JT. Treatment of myocardial infarction in a coronary care unit. Am J Cardiol. 1967;20(4):457-464.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Same specialty

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.