Cardiology

Canadian Cardiovascular Society (CCS) Angina Grading

Classifies severity of angina pectoris into functional classes to guide investigation and treatment.

Score interpretation

CCS Class I — Mild Angina 1

Angina with strenuous exertion only. No limitation of ordinary daily activities.

→ Medical management. Risk factor optimisation. Elective stress testing and cardiology review.

CCS Class II — Moderate Angina 2

Slight limitation of ordinary activity. Angina walking more than 2 blocks or climbing >1 flight.

→ Optimise antianginal therapy (nitrates, beta-blockers, CCBs). Consider stress testing and angiography.

CCS Class III — Severe Angina 3

Marked limitation. Angina walking 1–2 blocks on flat or climbing one flight of stairs.

→ Urgent cardiology referral. Coronary angiography. Consider revascularisation (PCI/CABG).

CCS Class IV — Very Severe / Rest Angina 4

Inability to carry out any physical activity without angina. Symptoms may occur at rest.

→ Urgent/emergency cardiology assessment. Hospital admission likely needed. Early angiography.

Interpretation bands for the CCS Angina. Apply clinical judgement and local guidance.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.