11/29/23, 2:31 PM Unstable Angina - Cardiovascular Disorders - MSD Manual Professional Edition

Braunwald Classification of Unstable Angina*

Classification Description Designation

Severity

New onset of severe angina or

I increasing† angina —
No angina during rest

Angina during rest within the past

II month but not within the preceding 48 Subacute angina at rest
hours

Angina during rest within the

III‡ Acute angina at rest
preceding 48 hours

Clinical situation

Develops secondary to an extracardiac

Secondary unstable
A condition that worsens myocardial
angina
ischemia

Develops when no contributory Primary unstable

B‡
extracardiac condition is present angina

Post-myocardial
Develops within 2 weeks of acute
C infarction unstable
myocardial infarction
angina

* Basic classification consists of a Roman numeral and a letter.

† Angina occurs more frequently, is more severe, lasts longer, or is triggered by less
exertion.

‡ For patients with class IIIB, troponin status (negative or positive) is determined to
estimate prognosis.

Adapted from Hamm CW, Braunwald E: APACHE II: A classification of unstable angina
revisited. Circulation 102:118–122, 2000.

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