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Killip Class IV
Definition 1
A classification of myocardial infarction characterized by cardiogenic shock; an event with systolic BP less than 90 mmHg for greater than 30 minutes, not responsive to fluid resuscitation alone, and felt to be secondary to cardiac dysfunction. Associated signs of hypoperfusion (cool and clammy skin, oliguria, or altered sensorium) or a cardiac index of less than 2.2 L/min/m2 are present. This includes when the systolic BP increases to greater than 90 mmHg in response to inotropic agents in less than 1 hour.) (NCI Thesaurus)
Definition 2
The presence of cardiogenic shock (systolic BP less than 90 mm Hg) for greater than 30 minutes, not responsive to fluid resuscitation alone, and felt to be secondary to cardiac dysfunction. (ACC/AHA) (NCI Thesaurus/CDISC)