A history of myocardial infarction automatically places a patient in which ASA physical status class?

• A. ASA 2
• B. ASA 4
• C. ASA 3
• D. ASA 5

Answer: (C)

A history of myocardial infarction signals significant cardiac disease that raises the baseline risk, but if the patient is currently stable without ongoing ischemia or heart failure, this places them in a severe systemic disease category that is not an immediate life threat. That balance is what ASA III represents: substantial systemic disease with functional limitations, but not a constant threat to life. If there were active ischemia, decompensated heart failure, or other unstable cardiac conditions, the status would be higher, into ASA IV, indicating a constant threat to life. The remaining categories describe more extreme or moribund states. So, a past MI with stability fits ASA III.