View Full Version : ASA Classification. What the heck???

11-26-2008, 02:10 PM
I had a procedure recently which required general anesthesia.

The anesthesiologist was a real nice guy, surprisingly knowledgeable about HCM, and spent quite a bit of time with me discussing my recent medical history, my HCM symptoms, and my recurrent bouts of heart failure, which he was able to pull up via my hospital records. After recieving copies of the surgical reports however, I was quite surprised to read:

"Immediately prior to sedation the patient's ASA Classification was Class 4: Severe systemic disease that is a constant threat to life."

What the heck???

Was this guy being overly dramatic, or have I become so complacent with my HCM that I have lost sight of just how severe my situation is? I must admit that I have had some very troubling times recently, especially with regard to heart failure, but I certainly never thought I was at death's door.

I just don't know what to make of this.

Has anyone else seen a report like this? Is this a normal clasification for HCM patients?


Lisa Salberg
11-26-2008, 03:20 PM
ASA stands for American Society of Anesthesiologists. In 1963 the ASA adopted a five category physical status classification system for assessing a patient before surgery. A sixth category was later added. These are:

1. A normal healthy patient.
2. A patient with mild systemic disease.
3. A patient with severe systemic disease.
4. A patient with severe systemic disease that is a constant threat to life.
5. A moribund patient who is not expected to survive with or without the operation.
6. A declared brain-dead patient whose organs are being removed for donor purposes.

As HCM has the chance of SCA - I am guessing that is why he made the choice of 4, I have seen it reported anywhere from 1 to 4 and sometimes the number varies in the same patient based on the Anesthesiologist.

I would not worry about it too much.

11-26-2008, 08:15 PM
This is really interesting, and I can see why he chose 4 because HCM is chronic and technically, yes, it is a "constant threat." However, the risk of SCA (sudden death) is very low, like 3% or something like that, for us. Keep in mind doctors need to do a certain amount of CYA when they review your condition! Especially anethesiologists.

Your doctors would tell you if you were "at death's door," Jim.

Happy Thanksgiving!!!