CHA₂DS₂-VASc Score
Neurology
Stroke risk in non-valvular atrial fibrillation, read as the treatment threshold it actually is.
How it is calculated
- Congestive heart failure or left ventricular dysfunction scores 1, hypertension 1, diabetes 1, vascular disease 1, and female sex 1.
- Age 75 or over scores 2, and prior stroke, TIA or thromboembolism scores 2.
- Age 65 to 74 scores 1 — but never in addition to the 2 points for 75 and over. The age criterion contributes one value or the other, not both.
- Female sex is a risk modifier rather than a risk factor on its own. A woman with no other factor scores 1 and is still managed as low risk.
- Guidelines recommend oral anticoagulation at 2 or more non-sex points, and say it should be considered at 1.
- No annual stroke percentage is shown here, deliberately. Published per-score rates differ substantially between cohorts — the original Euro Heart Survey table is not even monotonic — and the score is used as a treatment threshold rather than as a precise risk estimate.
- It applies to non-valvular atrial fibrillation only. Moderate-to-severe mitral stenosis and mechanical valves are anticoagulated regardless.
References
- Lip GYH, Nieuwlaat R, Pisters R, Lane DA, Crijns HJGM. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach. Chest 2010;137:263-272.
- Hindricks G, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation. Eur Heart J 2021;42:373-498 — for the treatment thresholds used here.
About these tools
OcuLearning Clinical Tools is part of an educational platform. These calculators are provided for learning and reference, and are not medical advice, a diagnosis, or a treatment recommendation.