Profile | Description | Time to MCS |
1 | Critical cardiogenic shock – "crash and burn": Patients with life-threatening hypotension despite rapidly escalating ionotropic support, critical organ hypoperfusion, often confirmed by worsening acidosis and/or lactate levels. | Within hours |
2 | Progressive decline – "sliding on inotropes": Patients with clinical deterioration despite intravenous ionotropic support, may be manifest by worsening renal function, nutritional depletion, volume overload, or inability to tolerate ionotropic therapy (due to tachyarrhythmia, ischemia or other adverse effect). | Within a few days |
3 | Stable but inotrope dependent – "dependent stability": patients with stable blood pressure and clinical status on inotropic support (or a temporary circulatory support device or both) but demonstrating repeated failure to wean from support due to recurrent symptomatic hypotension, worsening symptoms, or renal dysfunction. | Within a few weeks |
4 | Resting symptoms – "recurrent advanced heart failure": patients at home on oral therapy but experiences daily symptoms of congestion at rest of during activities of daily living (ADL). | Within weeks to months |
5 | Exertion intolerant: patients comfortable at rest (and with ADL) but unable to engage in any other activity. | Variable urgency |
6 | Exertion limited – "walking wounded": patients without evidence of fluid overload is comfortable at rest and with ADL and can perform minor activities outside the home but fatigues after the first few minutes of any meaningful physical exertion. | Variable |
7 | Advanced NYHA III: patients living comfortably with meaningful activity limited to mild physical exertion and no recent episodes of decompensation. | Not candidate for MCS |
Do you want to add Medilib to your home screen?