Classification of Angina

Classification of Angine according to the Canadian Cardiovascular Society.

Stable Angina

Class 1: No limitation: Ordinary physical activity does not cause angina such as walking or climbing stairs. Angina with strenuous or rapid or prolonged exertion at work or recreation

Class 2: Slight limitation of ordinary activity. Walking or climbing stairs rapidly, walking uphill, climbing stairs or after meals or in cold weather, wind, under emotional stress or pain during the first hrs. after waking up. Walking more than 2 blocks on the level or climbing more than one flight of stairs at a normal pace in normal conditions.

Class 3: Marked limitation or ordinary activity. Walking one to two blocks on the level and climbing one flight of stairs in normal conditions and at a normal pace.

Class 4: Inability to carry on any physical activity without discomfort. Symptoms of angina are present even at rest.

Unstable Angina

Class I: New onset, severe or accelerated angina. Subjects with angina of less than 2 months duration. Severe or occurring three or more times per day. Angina that is distinctly more frequent and precipitated by distinctly less exertion. No rest pain in the last 2 months.

Class II: Angina at rest, subacute. Subjects with one or more episode of angina at rest during the preceding month but not within the preceding 48 hrs.

Class III: Angina at rest, acute. Subjects with one or more episodes of angina at rest within the preceding 48 hrs.

Clinical Circumstances

Class A: secondary unstable angina. A clearly identified condition extrinsic to the coronary vascular bed that has intensified myocardial ischemia e.g. anemia, fever, infection, hypotension, tachyarrhythmia, thyrotoxicosis

Class B: Primary unstable angina

Class C: post infarction unstable angina (within 2 weeks of MI)

To do before de-stubbing

• What is the relevance of this? I took it from the paper manual, but it does not say there why included. Dx coding? APACHE II Chronic entry?
  • The relevance is for all of these things.--LKolesar 21:24, 15 May 2008 (CDT)
    • If the relevance is for all diagnoses, then we should include the diagnosis codes (like in the other dxs) and add it to the diagnosis. If it's for APACHE II, it would be nice to explain the relevance a touch better. If I understand right, we pull the angina score for the APACHE II from the L_Dxs entries, right? If so, then really for APACHE II all we should say is that it's pulled from there, and then link to the Angina DX coding entry, as not to duplicate text in here which can then become inconsistent. Ttenbergen 09:43, 16 May 2008 (CDT)
• provide better reference - the Canadian Cardiovascular Society website only has some of this at best.