Modified Canadian Cardiovascular Society grading of angina pectoris.

Modified Canadian Cardiovascular Society

grading of angina pectoris

Canadian Cardiovascular Society grading of angina pectoris contain only 4 grades and Class 0 is not an official part of the CCS functional classification of angina pectoris, however it has been mentioned in several sources, referring to myocardial ischemia without symptoms.

Grade 0	Asymptomatic Angina	Mild myocardial ischemia with no symptoms.
Grade I	Angina only with strenuous exertion	Angina with strenuous or rapid or prolonged exertion at work or recreation (Ordinary physical activity does not cause angina, such as walking and climbing stairs).
Grade II	Angina with moderate exertion	Slight limitation of ordinary activities when they are performed rapidly, after meals, in cold, in wind, under emotional stress, during the first few hours after waking up, but also walking uphill, climbing more than one flight of ordinary stairs at a normal pace and in normal conditions.
Grade III	Angina with mild exertion	Having difficulties walking one or two blocks or climbing one flight of stairs at normal pace and conditions.
Grade IV	Angina at rest	No exertion needed to trigger angina.

 Dr Ibrahim

Return to list of medical grades (click here)

- Criteria of hypersplenism.

Criteria of hypersplenism.

1. Splenomegally.
2. Cytopenias (mono or pan).
3. Hypercellular bone marrow.
4. Scanning with Cr51 labelled with RBCs>> reversed liver to spleen ratio.
5. Splenectomy will improve the condition.

(A huge spleen after splenectomy for female patient with hypersplenism)

Dr Ibrahim samaha

- Eye signs of thyrotoxicosis.

Eye signs of thyrotoxicosis.

"DR Joffroy may validate symptoms"

• Dalrymple sign:- rim of sclera is seen all around the cornea, on looking straight forward.
• Rosenbach's sign:- fine tremor of the upper eyelids on slight closure of the eye.
• Joffroy's sign:-lack of wrinkling of the forehead when a patient looks upward.
• Moebius sign:- lack of convergence on looking to near object.
• Von Graefe's sign (lid lag sign):-lagging of the upper eyelid on looking downward without movinh the head.
• Stellwag's sign:-staring look with infrequent blinking.

Dr Ibrahim,,

- Causes of gynecomastia.

Causes of gynecomastia.
Gynecomastia.

• Genetic : klinefelter syndrome.
• Young boy (puberty): due to transient increase of plasma estradiol.
• Neonate: due to persistent maternal or placental lactogens.
• Estrogen and estrogen like drugs (e.g. digitalis).
• Cirrohosis,Cimetidine,Cytotoxic drugs.
• Old age(due to conversion of androgen to estrogen in extra glandular tissue),Overactive thyroid (Hyperthyroidism)
• Myxedema,Marijuana.
• Acromrgally.
• Spironolactone,Steroids.
• Tumour (e.g. testis,adrenal,bronchogenic carcinoma).
• INH,Iron deposition in testis.
• Alcoholism.