Canadian Cardiovascular Society Grading System for Stable Angina 

Updated: Jun 12, 2014
  • Author: Buck Christensen; more...
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Canadian Cardiovascular Society Grading System for Stable Angina

The Canadian Cardiovascular Society Grading System for exertion-induced angina is used to gauge symptom severity. [1, 2, 3, 4]

Grade I

Grade I stable angina develops upon strenuous, rapid, and/or prolonged exertion during work or recreation but is not induced by ordinary physical activity, such as walking and climbing stairs.

Grade II

Grade II stable angina is characterized by a slight limitation of ordinary activity and is induced by the following:

  • Walking or climbing stairs rapidly
  • Walking uphill
  • Walking or stair-climbing after meals
  • Walking more than two level blocks or climbing more than one flight of ordinary stairs at a normal pace and in normal conditions
  • Emotional stress
  • During the few hours after waking

Grade III

Grade III stable angina is characterized by marked limitation of ordinary physical activity. It is induced by walking one or two level blocks and climbing one flight of stairs in normal conditions and at a normal pace.

Grade IV

Grade IV stable angina is characterized by an inability to carry on any physical activity without discomfort. Anginal syndrome may be present at rest.