Hemodynamic Index of Rackley et al After an Acute Myocardial Infarction

Rackley et al used the pulmonary artery occlusive pressure and cardiac index to classify a patient after an acute myocardial infarction.

NOTE: The same parameters but different decisions points are used in 06.08.11 (Hemodynamic Parameters and Risk after Myocardial Infarction).

Parameters:

(1) pulmonary artery occlusive pressure (PAOP) in mm Hg

(2) cardiac index in liters per minute per square meter

where:

• No class was listed for a PAOP of 20-24 mm Hg and cardiac index <= 2.5. I divided Class III in to IIIA and IIIB.

Class	Category	Management
I	hypovolemic	treat aggressively if recurrent chest pain or hypertension, else watch
II	hypovolemic	treat aggressively
III	optimum	watch
IV	pulmonary congestion	treat pulmonary edema and hypoxemia
V	cardiogenic shock	treat aggressively

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