A patient admitted with acute myocardial infarction has bibasilar crackles on auscultation and an S3 gallop, but normal blood pressure and warm peripheries. According to the Killip classification, this corresponds to which class?
- A Killip class I
- B Killip class II
- C Killip class III ✓
- D Killip class IV
Correct answer: C. Killip class III
Explanation
Killip class I has no signs of heart failure, class II has rales or an S3 without frank pulmonary edema, class III is overt pulmonary edema with rales extending beyond the lung bases plus an S3 gallop, and class IV is cardiogenic shock with hypotension and peripheral hypoperfusion. The presence of an S3 with extensive crackles places this patient in class III, which carries substantially higher mortality than class II.
Reference: Braunwald's Heart Disease, 12th ed.
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