Ccs classification of angina pectoris

The CCS classification of angina pectoris was first described in the literature by the Canadian Cardiovascular Society (CCS) in 1976 (Campeau 1976). Today it is still a globally recognized classification (Campeau 2002).

Stable angina pectoris is divided into 4 degrees of severity according to the classification of the Canadian Cardiovascular Society (CCS).

The CCS classification differentiates between the following degrees of severity:

• CCS grade I: There are no symptoms of any kind under normal everyday stress. Only during very high and continuous exertion (e.g. snow clearing, endurance running etc. [Dißmann 2019]) AP- attacks occur.
• CCS- Grade II: There are only minor restrictions during normal activities. AP occurs, for example, when climbing stairs to more than one floor, climbing mountains, in cold weather, after meals, emotional stress, walking > 100 m, etc.
• CCS- grade III: Here there is a clear limitation of the daily performance. AP occurs when getting dressed, walking slowly, doing housework (Dißmann 2019), walking distances < 100 m, climbing stairs from one floor, etc.
• CCS grade IV: AP occurs at rest or at the slightest physical stress. This degree of severity is already partly assessed as unstable AP (Dißmann 2019, Kasper 2015).

The assignment of CCS to the individual degrees of severity is not possible or does not make sense for many patients due to multiple triggers of AP. The problem is known, but a reformation of the classification is not yet available (Pinger 2019).

1. Campeau L (1976) Grading of angina pectoris. Circulation 54: 522 - 523
2. Campeau L (2002) The Canadian Cardiovascular Society grading of angina pectoris revisited 30 years later. The Canadian Journal of Cardiology 18: 371 - 379
3. Dißmann R et al. (2019) German Medical Association (BÄK), Federal Association of Statutory Health Insurance Physicians (KBV), Association of the Scientific Medical Societies (AWMF). National Health Care Guideline Chronic CHD - Long Version, 5th Edition. Version 1. 2019
4. Kasper D L et al (2015) Harrison's Principles of Internal Medicine. Mc Graw Hill Education S 1581
5. Pinger S (2019) Repetitorium Kardiologie: For clinic, practice, specialist examination. German Medical Publisher S 29