What is the Canadian Cardiovascular Society Grading System for unstable angina?

Updated: Oct 01, 2020
  • Author: Walter Tan, MD, MS; Chief Editor: Eric H Yang, MD  more...
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Answer

Because of its simplicity and practicality, the Canadian Cardiovascular Society Grading System for effort-related angina is widely used to describe symptom severity. The grading system is as follows:

  • Grade I – Angina with strenuous, rapid, or prolonged exertion; ordinary physical activity, such as climbing stairs, does not provoke angina

  • Grade II – Slight limitation of ordinary activity; angina occurs with postprandial, uphill, or rapid walking; when walking more than 2 blocks of level ground or climbing more than 1 flight of stairs; during emotional stress; or in the early hours after awakening

  • Grade III – Marked limitation of ordinary activity; angina occurs with walking 1-2 blocks or climbing a flight of stairs at a normal pace

  • Grade IV – Inability to carry on any physical activity without discomfort; rest pain occurs


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