Canadian cardiovascular society classification of angina pectoris

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

The Canadian Cardiovascular Society, classifies the severity of anginal symptoms in patients with chronic stable angina based on the functional impairment of the patient and also quantifies the response to therapy.

Canadian Cardiovascular Society Severity Classification (CCS)

Class	Canadian Cardiovascular Society Severity Classification
Class I	Ordinary physical activity does not cause angina, such as walking, climbing stairs. Angina occurs with strenuous, rapid or prolonged exertion at work or recreation.
Class II	Slightly limited ordinary physical activities. Angina occurs on: walking or climbing stairs rapidly, walking uphill, walking or stair climbing after meals, or in cold, or in wind, or under emotional stress, or only during the few hours after awakening. Walking more than two blocks on the same level and climbing more than one flight of ordinary stairs at a normal pace and in normal condition.
Class III	Marked limitations of ordinary physical activity. Angina occurs on walking one to two blocks (equivalent to 100-200m) on the same level and climbing one flight of stairs at a normal pace under normal conditions.
Class IV	Inability to carry on any physical activity without any discomfort. Angina occurs at rest.

See also

Other frequently used functional classifications of cardiovascular disease include:

• New York Heart Association Functional Classification for grading dyspnea and heart failure.
• Duke Specific Activity Index

References

• Hurst’s Heart Disease, Fuster V, 12th edition, 2008
• Canadian Cardiovascular Society