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The Canadian Cardiovascular Society Classification of Angina

The Braunwald Classification of Unstable Angina

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The Canadian Cardiovascular Society Classification of Angina Pectoris

The Canadian Cardiovascular Society Classification of Angina Pectoris separates patients with anginal symptoms into groups based on the severity of their symptoms. The classification uses the extent of limitation on daily activities and the kind of physical activity which precipitates the anginal episode.

 

Clinical Findings Features Grade
No limitation of ordinary activity. Ordinary physical activity (such as walking or climbing stairs) does not cause angina. Angina may occur with strenuous rapid or prolonged exertion at work or recreation. I
Slight limitation of ordinary activity. Angina may occur with
• walking or climbing stairs rapidly;
• walking uphill;
• walking or stair climbing after meals or in the cold in the wind or under emotional stress;
• walking more than 2 blocks on the level at a normal pace and in normal conditions
• climbing more than 1 flight of ordinary stairs at a normal pace and in normal conditions.
II
Marked limitation of ordinary physical activity. Angina may occur after
• walking 1-2 blocks on the level or
• climbing 1 flight of stairs in normal conditions at a normal pace.
III
Unable to carry on any physical activity without discomfort. Angina may be present at rest. IV

The Braunwald Classification of Unstable Angina

The Braunwald Classification of Unstable Angina facilitates the assignment of patients to a particular risk group according to the severity of symptoms, the clinical circumstances surrounding the anginal episode, and the intensity of treatment.

 

Severity
Clinical Circumstances
A
B
C
Develops in presence of extracardiac condition that intensifies myocardial ischemia (secondary UA) Develops in the absence of extracardiac condition (primary UA) Develops within 2 weeks after acute myocardial infarction (postinfarction UA)
I New onset of severe angina or accelerated angina; no rest pain
IA
IB
IC
II Angina at rest within past month but not within preceding 48 hr (angina at rest, subacute)
IIA
IIB
IIC
III Angina at rest within 48 hr (angina at rest, acute)
IIIA
IIIB Troponin negative
IIIB Troponin positive
IIIC

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