Unifying Concepts

Classification and Severity of Angina

Class I

No angina with ordinary physical activity (e.g., walking, climbing stairs). Angina with strenuous or prolonged exertion.

Class II

Early-onset limitation of ordinary activity (e.g., walking rapidly or walking >2 blocks; climbing stairs rapidly or climbing >1 flight); angina may be worse after meals, in cold temperatures, or with emotional stress.

Class III

Marked limitation of ordinary activity.

Class IV

Inability to carry out any physical activity without chest discomfort. Angina occurs during rest.



  1. Abrams J. Clinical practice. Chronic stable angina. N Engl J Med. 2005 Jun 16;352(24):2524-33. [Medline]
  2. Sangareddi V, Chockalingam A, Gnanavelu G, Subramaniam T, Jagannathan V, Elangovan S. Canadian Cardiovascular Society classification of effort angina: an angiographic correlation. Coron Artery Dis 2004;15:111-114. [Medline]


Created: Sep 05, 2008

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