Which clinical finding correctly places a patient with acute STEMI in Killip class III?
- A Pulmonary oedema with crackles extending over more than half of the lung fields ✓
- B An S3 gallop alone with clear lung fields
- C Bilateral basal crackles confined to less than half of the lung fields
- D Systolic blood pressure below 90 mmHg with cold clammy extremities
Correct answer: A. Pulmonary oedema with crackles extending over more than half of the lung fields
Explanation
The Killip classification grades heart failure clinically after MI: class I has no failure, class II has crackles limited to less than 50 percent of lung fields or an S3, class III is overt pulmonary oedema with crackles over more than half of the lung fields, and class IV is cardiogenic shock. In-hospital mortality rises progressively across classes. Option D describes class IV, and option B belongs to class II.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.