A 64-year-old man admitted with acute anterior MI is found to have diffuse bilateral crepitations up to the mid-zones, orthopnoea, and a chest X-ray showing pulmonary oedema. Blood pressure is 110/70 mmHg with adequate urine output. According to the Killip classification of heart failure in MI, he belongs to which class?
- A Killip class III ✓
- B Killip class II
- C Killip class I
- D Killip class IV
Correct answer: A. Killip class III
Explanation
Killip class III denotes frank pulmonary oedema, defined by widespread rales extending beyond the lung bases with radiological congestion. Class II covers basal rales or an S3 gallop without frank oedema, which is the trap here since isolated basal crackles would fit class II. Class IV is cardiogenic shock with hypoperfusion and systolic BP below 90 mmHg, absent in this patient.
Reference: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 12th ed.
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