Heart Disease Classifications
15.3.10 Heart Disease Classifications
Several classifications pertaining to heart disease are in use:
Braunwald class I
Braunwald class IIIB
CCS class II
Cardiac function after myocardial infarction
Forrester class I
Cardiac status after myocardial infarction
Killip class I heart failure
Cardiac disease and functional capacity
NYHA class I
The classes are assessed in various ways, for instance, by physical examination (Killip), hemodynamic measurement (Forrester), and patient history (NYHA). The detailed meanings of each class are beyond the scope of this book, but several style points may be noted:
▪ Severity increases from lower to higher numbers and letters.
▪ There is no automatic correspondence between classes (eg, Killip class I is not equivalent to NYHA class I).
▪ The numerals are designators and are not quantitative or semiquantitative. Therefore, roman numerals are appropriate.
Forrester class >2
Forrester class above II
class greater than Forrester II
Forrester classes III and IV
▪ Authors should describe their classification criteria, for instance:
Killip class on admission was determined as the following: patients in class I were free of rales and a third heart sound; patients in class II had rales up to 50% of each lung field regardless of the presence of the third heart sound…(adapted from Neskovic et al21).
We suggest that cases of unstable angina class IIIB now be subdivided into troponin-positive and troponin-negative subgroups … (adapted from Hamm and Braunwald22[p120]).