grading of effort angina

Last reviewed 01/2018

The Canadian Cardiovascular Society classification of angina recognises four levels of severity:

• Class I:
  • ordinary physical activity does not cause angina
  • strenuous or rapid or prolonged physical activity provokes angina
    
    
• Class II:
  • some limitation of ordinary physical activity
  • provocation of angina caused by walking or climbing stairs rapidly, walking uphill or exertion after meals, in cold weather, when under emotional stress, or only during the first few hours after awakening o exercise tolerance 100-200 m before angina
    
    
• Class III:
  • marked limitation of ordinary physical activity
  • angina on walking one or two blocks on the level or one flight of stairs at a normal pace under normal conditions
    
    
• Class IV:
  • severely disable by angina and inability to carry out any physical activity without discomfort
  • angina on minimal exertion or angina at rest

Reference:

• 1. Fox K et al. Guidelines on the management of stable angina pectoris: executive summary. European Heart Journal 2006;27(11):1341-1381