Grading of Angina Pectoris by the Canadian Cardiovascular Society Classification System

Table B Grading of Angina Pectoris by the Canadian Cardiovascular Society Classification System

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
Slight limitation of ordinary activity. 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. Angina occurs on walking more than 2 blocks on the 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 on the level and climbing one flight of stairs in normal conditions and at a normal pace.
Class IV
Inability to carry on any physical activity without discomfort—anginal symptoms may be present at rest.

From Campeau L. Grading of angina pectoris [letter]. Circulation. 1976;54:522–3 (14). Copyright 1976 American Heart Association, Inc. Reprinted with permission.