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Cardiovascular
CHA₂DS₂-VASc Score
Estimate stroke risk in non-valvular atrial fibrillation to guide anticoagulation.
When to use: Apply CHA₂DS₂-VASc to all patients with non-valvular atrial fibrillation (AF) to quantify annual stroke risk and decide on anticoagulation. ESC 2020 guidelines recommend anticoagulation for score ≥2 in men and ≥3 in women, with consideration at score 1 (men) / 2 (women). Always pair with HAS-BLED to assess bleeding risk before prescribing.
Calculator
Do not select if age ≥ 75
Female sex adds 1 point as a risk modifier (not standalone risk factor)
Fill in all fields to see the result
Formula
CHA₂DS₂-VASc = CHF(1) + Hypertension(1) + Age≥75(2) + Diabetes(1) + Stroke/TIA(2) + Vascular disease(1) + Age 65-74(1) + Female sex(1)
Max score = 9
Key Points for NEET PG
- Mnemonic: C-H-A₂-D-S₂-V-A-Sc — Cardiac failure, Hypertension, Age≥75 (×2), Diabetes, Stroke (×2), Vascular disease, Age 65-74, Sex category (female).
- Maximum score is 9. A score of 0 in males (or 1 due to female sex alone) = low risk, no anticoagulation.
- DOACs (apixaban, rivaroxaban, dabigatran) are preferred over warfarin in non-valvular AF per current guidelines.
- Valvular AF (rheumatic mitral stenosis or mechanical heart valve) always requires anticoagulation with warfarin — DOACs are CONTRAINDICATED.
- Female sex is a risk modifier, not a standalone independent risk factor — a woman with score 1 (sex only) is still low risk.
References
Lip GY et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach · Chest (2010)
ESC Guidelines for the diagnosis and management of atrial fibrillation 2020 · Eur Heart J (2021)
For educational purposes only. Not for clinical decision-making without professional oversight.