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CHA₂DS₂-VASc Calculator

Assess stroke risk in atrial fibrillation patients for anticoagulation decisions

Assess Stroke Risk Factors

Signs/symptoms with objective evidence (e.g., reduced EF on echo)

0 points

BP >140/90 mmHg on two occasions or current antihypertensive treatment

0 points

Age 65-74 years (1 point), ≥75 years (2 points)

0 points

Current insulin/antidiabetic drugs or fasting glucose >125 mg/dL

0 points

Prior stroke, TIA, thromboembolism, or cerebral ischemia (2 points)

0 points

Prior MI, peripheral artery disease, or aortic plaque

0 points

Female sex (1 point only if other risk factors present)

0 points

CHA₂DS₂-VASc Score Results

0
CHA₂DS₂-VASc Score
Low RiskScore: 0

Patient has isolated atrial fibrillation with very low stroke risk

Recommendation: No oral anticoagulation required

Annual Stroke Risk
0.2%
Total Thromboembolic Risk
0.3%

Score Breakdown

Example Assessment

Patient Example

Patient: 68-year-old female with atrial fibrillation

Medical History: Hypertension, no diabetes

No history of: CHF, stroke/TIA, vascular disease

Score Calculation

• Age 65-74: +1 point

• Hypertension: +1 point

• Female gender: +1 point

Total Score: 3 points

High Risk: Oral anticoagulation recommended
Annual stroke risk: 3.2%

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Risk Stratification

Score 0-1*Low Risk
Score 1 (male)Moderate Risk
Score ≥2High Risk

*Score 1 in females only if isolated AF (no other risk factors)

Annual Stroke Risk by Score

Score 0:0.2%
Score 1:0.6%
Score 2:2.2%
Score 3:3.2%
Score 4:4.8%
Score 5:7.2%
Score ≥6:≥9.7%

CHA₂DS₂-VASc Acronym

CCongestive heart failure
HHypertension
A₂Age ≥75 (2 points)
DDiabetes mellitus
S₂Stroke/TIA (2 points)
VVascular disease
AAge 65-74
ScSex category (female)

Medical Disclaimer

This calculator is for educational purposes only and should not replace professional medical advice. The CHA₂DS₂-VASc score is a clinical decision support tool that must be interpreted by qualified healthcare professionals. Individual patient factors, bleeding risk assessment (HAS-BLED score), and clinical judgment should always guide anticoagulation decisions. Always consult with a cardiologist or healthcare provider before starting or stopping anticoagulant therapy.

Understanding CHA₂DS₂-VASc Score

What is CHA₂DS₂-VASc?

The CHA₂DS₂-VASc score is a clinical prediction rule for estimating the risk of stroke in patients with atrial fibrillation. It helps clinicians decide whether anticoagulant therapy is warranted to prevent thromboembolic complications.

When to Use

  • All patients with atrial fibrillation
  • Before starting anticoagulation therapy
  • Annual reassessment of stroke risk
  • Combined with bleeding risk assessment

Clinical Applications

Low Risk (0-1 points)

No anticoagulation required

Moderate Risk (1 point male)

Consider anticoagulation

High Risk (≥2 points)

Anticoagulation recommended

Important: Always assess bleeding risk using HAS-BLED score alongside CHA₂DS₂-VASc

Key Clinical Considerations

Risk Factor Details

  • • CHF: Objective evidence required (echo, clinical signs)
  • • HTN: BP >140/90 on two occasions or on treatment
  • • Age: 65-74 years (1 pt), ≥75 years (2 pts)
  • • DM: On treatment or fasting glucose >125 mg/dL
  • • Female: Only counts if other risk factors present

Treatment Considerations

  • • Score >2: Strong indication for anticoagulation
  • • Score 1 (male): Individual assessment needed
  • • Consider bleeding risk (HAS-BLED score)
  • • Patient preferences and contraindications
  • • Regular monitoring and reassessment
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