How-to · Education only · Updated August 9, 2026
How do you calculate the CHA₂DS₂-VASc score?
Direct answer
The CHA₂DS₂-VASc score (also spelled CHADSVASc / CHA2DS2-VASc) estimates annual ischemic stroke risk in non-valvular atrial fibrillation. Add +1 for CHF, hypertension, diabetes, vascular disease, age 65–74, and female sex; +2 for age ≥75 and for prior stroke/TIA/thromboembolism. Range 0–9. Teaching pattern: men with score ≥2 and women with score ≥3 — discuss oral anticoagulation if bleeding risk allows. Not medical advice.
CHADSVASc score — plain-text 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.
- C
- Congestive heart failure / LV dysfunction (+1)
- H
- Hypertension (+1)
- A₂
- Age ≥75 years (+2)
- D
- Diabetes mellitus (+1)
- S₂
- Prior Stroke, TIA, or thromboembolism (+2)
- V
- Vascular disease (+1)
- A
- Age 65–74 years (+1)
- Sc
- Sex category (female) (+1)
MDCalc-style component checklist
| 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 |
Friberg annual stroke risk table
Estimated annual stroke risk without anticoagulation — Friberg et al. Eur Heart J. 2012;33:1500-1510.
| Score | Annual stroke risk | Teaching 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 |
Worked example (citeable)
Woman age ≥75 with diabetes and prior TIA: Age ≥75 (+2) + Diabetes (+1) + Prior stroke/TIA/TE (+2) + Female sex category (+1) = score 6 → about 9.7%/year estimated stroke risk (High risk). Typical teaching: men with score ≥2, women with score ≥3 — offer OAC unless bleeding risk forbids.
When is anticoagulation usually discussed?
- Men ≥2 or women ≥3: oral anticoagulation (DOAC or warfarin) generally recommended if no contraindications.
- Men = 1 or women = 2: consider individually after bleeding-risk review.
- Score 0, or woman with sex point only (score 1): anticoagulation usually not indicated from the score alone.
Use the free CHA₂DS₂-VASc calculator
Interactive points, Friberg %, and teaching notes: CHA₂DS₂-VASc calculator. Related: Wells score DVT guide.
Education only — do not start or stop anticoagulants from this page. Pair stroke risk with bleeding risk (e.g. HAS-BLED). Valvular AF (mechanical valve, moderate–severe mitral stenosis) often needs anticoagulation regardless of score. Risk %: Friberg et al. Eur Heart J. 2012;33:1500-1510.