Acute infarction KILLIP grading is applied to the grading of heart failure due to acute myocardial infarction and is used to assess the cardiac functional status of patients with acute myocardial infarction. There are four grades: Grade I, no heart failure and no wet rales on auscultation in both lungs. Grade II, mild to moderate heart failure with less than 50% of both lungs rales on auscultation. Grade III, severe heart failure with pulmonary edema, with the extent of rales on auscultation in both lungs greater than 50% of both lungs. Grade IV, cardiogenic shock, the patient presents with a fall in blood pressure, systolic blood pressure less than 90 mmHg, little urine, wet and cold skin, accelerated breathing and other states of shock.