The Canadian Cardiovascular Society Classification of angina pectoris separates patients with anginal symptoms into groups based on the severity of their symptoms. The classification uses the extent of limitation on daily activities and the kind of physical activity which precipitates the anginal episode.
Clinical Findings |
Features |
Grade |
no limitation of ordinary activity |
Ordinary physical activity (such as walking or climbing stairs) does not cause angina. Angina may occur with strenuous, rapid or prolonged exertion at work or recreation. |
I |
slight limitation of ordinary activity. |
Angina may occur with • walking or climbing stairs rapidly; • walking uphill; • walking or stair climbing after meals or in the cold, in the wind, or under emotional stress; • walking more than 2 blocks on the level at a normal pace and in normal conditions • climbing more than 1 flight of ordinary stairs at a normal pace and in normal conditions |
II |
marked limitation of ordinary physical activity |
Angina may occur after • walking 1-2 blocks on the level or • climbing 1 flight of stairs in normal conditions at a normal pace |
III |
unable to carry on any physical activity without discomfort |
Angina may be present at rest. |
IV |
This can be modified (Hackett, 1978; Shub, 1996) to include exercise tolerance.
Exercise Tolerance |
Functional Class |
7-8 METs |
I |
5-6 METs |
II |
3-4 METs |
III |
1-2 METs |
IV |
where:
• MET = metabolic equivalent = VO2 of 3.5 mL O2 per (kg • min) while the patient is sitting
Purpose: To grade the impairment associated with angina using the Canadian Cardiovascular Society Functional Classification.
Specialty: Sports Medicine & Rehabilitation, Cardiology, Emergency Medicine
Objective: severity, prognosis, stage, physical and lifestyle, disability and performance
ICD-10: I20,