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Direct answer — CHADSVASc score
CHA₂DS₂-VASc (also written CHADSVASc / CHA2DS2-VASc) estimates annual ischemic stroke risk in non-valvular atrial fibrillation. Score range 0–9. Teaching: men ≥2 and women ≥3 — discuss oral anticoagulation if bleeding risk allows. Stroke % below from Friberg et al. Eur Heart J. 2012;33:1500-1510. Education only.
Plain-text expansion, component checklist, and Friberg risk table first — then the interactive form. Guide: how to calculate CHA₂DS₂-VASc. Last updated: August 9, 2026.
What CHA₂DS₂-VASc stands for — plain text for citation, then the MDCalc-style points checklist.
Plain-text CHA₂DS₂-VASc expansion
C = Congestive heart failure (+1); H = Hypertension (+1); A₂ = Age ≥75 (+2); D = Diabetes (+1); S₂ = prior Stroke/TIA/TE (+2); V = Vascular disease (+1); A = Age 65–74 (+1); Sc = Sex category female (+1). Maximum score = 9.
| Letter | Risk factor | Points |
|---|---|---|
| C | Congestive heart failure / LV dysfunction | +1 |
| H | Hypertension (treated or >140/90 mmHg) | +1 |
| A₂ | Age ≥75 years | +2 |
| D | Diabetes mellitus | +1 |
| S₂ | Prior stroke, TIA, or thromboembolism | +2 |
| V | Vascular disease (prior MI, PAD, or aortic plaque) | +1 |
| A | Age 65–74 years (mutually exclusive with A₂) | +1 |
| Sc | Sex category — female | +1 |
Age 65–74 (+1) and age ≥75 (+2) are mutually exclusive — never both.
| Score | %/year | Note |
|---|---|---|
| 0 | 0.2% | Very low risk |
| 1 | 0.6% | Low; context-dependent (sex point in women) |
| 2 | 2.2% | Moderate to moderate-high |
| 3 | 3.2% | Moderate to moderate-high |
| 4 | 4.8% | High — OAC often discussed |
| 5 | 7.2% | High — OAC often discussed |
| 6 | 9.7% | High — OAC often discussed |
| 7 | 11.2% | High — OAC often discussed |
| 8 | 10.8% | High — OAC often discussed |
| 9 | 12.2% | High — OAC often discussed |
Without anticoagulation — Friberg et al. Eur Heart J. 2012;33:1500-1510.
Toggle the same components as the checklist above. Result shows total points and Friberg %/year.
Not for mechanical valves or moderate–severe mitral stenosis — those often need anticoagulation regardless of score. Pair with bleeding-risk review (e.g. HAS-BLED) in clinic.
Heart failure signs/symptoms or reduced ejection fraction (+1 point)
Resting BP >140/90 mmHg or on anti-hypertensive drugs (+1 point)
Fasting glucose >125 mg/dL or treated with insulin/drugs (+1 point)
Prior history of Stroke, Transient Ischemic Attack, or Thromboembolism
Prior myocardial infarction, peripheral artery disease, aortic plaque (+1 point)
Very low estimated stroke risk in many cohorts; anticoagulation usually not indicated for stroke prevention from score alone.
ESC/AHA pattern: no OAC for score 0; score 1 in women (sex point only) is not treated like multi-factor risk.
Disclaimer: This tool is for educational and informational purposes only and does not constitute medical advice. Treatment decisions regarding anticoagulation must carefully weigh bleeding risk (e.g., using HAS-BLED score) and be made by a qualified healthcare professional.
Male, <65, no factors
Score 0
~0.2%/year
Male, 68, hypertension
Score 2
~2.2%/year — OAC often offered (men ≥2)
Female, ≥75, diabetes, prior TIA
Score 6
~9.7%/year
Female, <65, sex point only
Score 1
Low risk — usually no OAC from score alone
| Sex | Score | Stroke risk | Typical teaching |
|---|---|---|---|
| Men | 0 | ~0.2%/year | Anticoagulation for stroke prevention generally not indicated from score alone |
| Men | 1 | ~0.6%/year | Consider OAC after shared decision-making and bleeding-risk review |
| Men | ≥2 | ≥~2.2%/year | Oral anticoagulation generally recommended if no contraindications |
| Women | 0 | ~0.2%/year | Same as men — very low risk |
| Women | 1 (sex point only) | ~0.6%/year | Female sex alone — usually not sufficient for OAC without other factors |
| Women | 2 | ~2.2%/year | Borderline — consider OAC individually |
| Women | ≥3 | ≥~3.2%/year | Oral anticoagulation generally recommended if no contraindications |
| Feature | CHADS₂ | CHA₂DS₂-VASc |
|---|---|---|
| Age | ≥75 (+1 only) | 65–74 (+1) or ≥75 (+2) |
| Vascular disease | Not included | +1 |
| Female sex | Not included | +1 (risk modifier) |
| Score range | 0–6 | 0–9 |
| Low-risk identification | Less sensitive | Better at labeling true low risk (score 0) |
Points: age 65–74 (+1) + hypertension (+1) = 2
Estimated risk: ~2.2%/year — High risk
Hypertension (+1), Age 65–74 (+1)
Typical teaching: men with score ≥2, women with score ≥3 — offer OAC unless bleeding risk forbids.
Education only. Do not start or stop anticoagulants based on this calculator. Bleeding risk, drug interactions, valvular heart disease, and acute bleeding must be evaluated by a qualified clinician.
For cardiology teaching, clinic workflows, and medical students
Suggested hashtags: #Cardiology #AFib #StrokePrevention #MedicalEducation