Table 3.11-9. Grading of angina pectoris based on its severity according to the Canadian Cardiovascular Society (CCS)

Grade I: Ordinary physical activity (such as walking and climbing stairs) does not cause angina. Angina occurs with strenuous, rapid, or prolonged exertion at work or recreation

Grade II: A slight limitation of ordinary activity. Angina occurs when:

– Walking or climbing stairs rapidly

– Walking uphill

– Walking or climbing stairs after meals, in cold, or in wind, or when under emotional stress, or only during the few hours after awakening

– Walking >200 meters or climbing more than 1 flight of stairs at a normal pace and in normal conditions

Grade III: Marked limitation of ordinary physical activity. Angina occurs when walking 100-200 meters or climbing 1 flight of stairs at a normal pace in normal conditions

Grade IV: Inability to carry on any physical activity without discomfort; anginal syndrome may be present at rest

Source: Canadian Cardiovascular Society. Canadian Cardiovascular Society grading of angina pectoris.