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Subjects/Anesthesia/ASA Physical Status
ASA Physical Status
medium
syringe Anesthesia

Which of the following clinical scenarios best describes an ASA physical status IV patient?

A. A. A 70-year-old male with a ruptured abdominal aortic aneurysm presenting in hypovolemic shock.
B. B. A 55-year-old female with unstable angina pectoris awaiting urgent coronary artery bypass grafting.
C. C. A 40-year-old male with severe traumatic brain injury and impending herniation.
D. D. A 60-year-old female with end-stage renal disease on regular hemodialysis, scheduled for AV fistula creation.

Explanation

ASA IV describes a patient with severe systemic disease that is a constant threat to life. Unstable angina pectoris is a classic example of an ASA IV condition, as it poses an immediate and constant threat to life due to myocardial ischemia. A. A ruptured abdominal aortic aneurysm in shock is typically classified as ASA V (a moribund patient not expected to survive without the operation). C. Severe traumatic brain injury with impending herniation is also typically ASA V due to the immediate life-threatening nature. D. A patient with end-stage renal disease on regular hemodialysis, if stable and undergoing an elective procedure like AV fistula creation, is usually classified as ASA III (severe systemic disease that is not incapacitating).

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