Canadian Cardiovascular Society Functional Classification of Angina

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

Exercise Tolerance

Functional Class

7-8 METs

I

5-6 METs

II

3-4 METs

III

1-2 METs

IV