Table 1.

Hemodynamic Characteristics of the SCAI Classification of Cardiogenic Shock^*

Stage		Physical Examination	Biochemical markers	Hemodynamics
A.	At Risk	Normal CVP, no rales, warm, good peripheral pulses, normal mentation	Normal labs, lactate and renal function	SBP >100 or normal for pt. If done: CI ≥2.5, CVP <10, SvO2 >65%
B.	Beginning CS	↑CVP, rales, good peripheral pulses, normal mentation	Minimal renal functional impairment, elevated BNP	SBP <90 or MAP <60 or >30 decrease, HR ≥100. If done: CI ≥2.2, SvO2 ≥65%
C.	Classic CS	May include any: Looks unwell, panicked, ashen, volume overload, rales, Killip class 3–4, cold/clammy, altered MS, decreased UO	May include any: Lactate>2, doubling creatinine or 50% drop in GFR, Increased LFTs, elevated BNP	May include any: SBP <90, MAP <60 or >30 decrease, and drugs/device used to maintain BP above target, CI <2.2, Ppao >15, CVP/Ppao ≥0.8, PAPI <1.85, CPO ≤0.6
D.	Deteriorating/Doom	Any of Stage C	Any of Stage C and deteriorating	Any of Stage C and require multiple pressors, mechanical circulatory support to maintain flow
E.	Extremis	Near pulselessness, cardiac collapse, mechanical ventilation, defibrillator used	“Trying to die” pH ≤7.2, lactate ≥5	No SBP without resuscitation, pulseless electrical activity, refractory VT/VF, hypotension despite maximal support

^*Abbreviations: Brain natriuretic peptide: BNP, cardiac index: CI, cardiac power output: CPO, cardiogenic shock: CS, central venous pressure: CVP, glomerular filtration rate: GFR, liver function tests: LFTs, mean arterial pressure: MAP, mental status: MS, mixed venous O₂ saturation: S_vO_2, pulmonary arterial occlusion pressure: P_pao, pulmonary artery pulsatility index: PAPI, patient: pt, systolic blood pressure: SBP, urine output: UO, ventricular tachycardia/fibrillation: VT/VF. Modified from reference 2. Baran et al. Catheter Cardiovasc Interv 2019;94:29-37.