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Table 17. INTERMACS Profiles
Profile*
Profile
Description Features
1 Critical
cardiogenic shock
Life-threatening hypotension and rapidly escalating
inotropic/pressor support, with critical organ
hypoperfusion oen confirmed by worsening acidosis
and lactate levels.
2 Progressive
decline
"Dependent" on inotropic support but nonetheless
shows signs of continuing deterioration in nutrition,
renal function, fluid retention, or other major status
indicator. Can also apply to a patient with refractory
volume overload, perhaps with evidence of impaired
perfusion, in whom inotropic infusions cannot be
maintained because of tachyarrhythmias, clinical
ischemia, or other intolerance.
3 Stable but
inotrope
dependent
Clinically stable on mild-moderate doses of intravenous
inotropes (or has a temporary circulatory support
device) aer repeated documentation of failure to
wean without symptomatic hypotension, worsening
symptoms, or progressive organ dysfunction (usually
renal).
4 Resting symptoms
on oral therapy at
home
Patient who is at home on oral therapy but frequently
has symptoms of congestion at rest or with activities
of daily living (dressing or bathing ). He or she may
have orthopnea, shortness of breath during dressing
or bathing, gastrointestinal symptoms (abdominal
discomfort, nausea, poor appetite), disabling ascites, or
severe lower extremity edema.
5 Exertion
intolerant
Patient who is comfortable at rest but unable to engage
in any activity, living predominantly within the house
or housebound.
6 Exertion limited Patient who is comfortable at rest without evidence of
fluid overload but who is able to do some mild activity.
Activities of daily living are comfortable, and minor
activities outside the home such as visiting friends or
going to a restaurant can be performed, but fatigue
results within a few minutes or with any meaningful
physical exertion.
7 Advanced NYHA
class III
Patient who is clinically stable with a reasonable
level of comfortable activity, despite a history of
previous decompensation that is not recent. is
patient is usually able to walk more than a block. Any
decompensation requiring intravenous diuretics or
hospitalization within the previous month should make
this person a Patient Profile 6 or lower.
