Table 5. INTERMACS Clinical Profiles
Level
Time Frame
for Intervention
Description
Hemodynamic Status
1
Critical
cardiogenic shock
– "crash and burn"
Persistent hypotension
Within hours
despite rapidly escalating
inotropic support and
eventually intraaortic
balloon pump (IABP), and
critical organ hypoperfusion
2
Progressive decline
on inotropic
support – "sliding
on inotropes"
Intravenous inotropic
support with acceptable
values of blood pressure and
continuing deterioration in
nutrition, renal function, or
fluid retention
Within days
3
Stable but inotrope
dependent –
"dependent
stability"
Stability reached with
mild to moderate
doses of inotropes but
demonstrating failure to
wean from them because
of hypotension, worsening
symptoms, or progressive
renal dysfunction
Elective over weeks
to months
4
Resting symptoms
– "frequent flyer"
Possible weaning of
inotropes but experiencing
recurrent relapses, usually
fluid retention
Elective over weeks
to months
5
Exertion
intolerant,
housebound
Severe limited tolerance for
activity, comfortable at rest
with some volume overload
and often with some renal
dysfunction
Variable urgency, dependent
on nutrition and organ
function
6
Exertion limited
– "walking
wounded"
Less severely limited
tolerance for activity and
lack of volume overload,
fatigue easily
Variable urgency, dependent
on nutrition and organ
function
7
Advanced NYHA
III – "symptoms,
placeholder"
Patient without current
or recent unstable fluid
balance, NYHA class II
or III
Not currently indicated
