CHA2DS2VaSc

Question 1

What is it used for?

Answer 1

Stroke risk in atrial fibrillation

Question 2

C

Answer 2

Congestive heart failure
1 point

Question 3

H

Answer 3

Hypertension
1 point

Question 4

A2

Answer 4

Age
65 ≤ age < 75 = 1 point

≥75 = 2 points

Question 5

D

Answer 5

Diabetes
1 point

Question 6

S2

Answer 6

Stroke/Tia
= 2 points

Question 7

Va

Answer 7

Vascular disease
= 1 point

Question 8

Sc

Answer 8

Sex category
Female = 1 point

Question 9

Score 0

Answer 9

no anticoagulation required

Question 10

Score 1

Answer 10

consider anticoagulation with vitamin K antagonist like warfarin within therapeutic range (INR 2–3) or a DOAC (rivaroxaban, apixaban), maybe aspirin.

Question 11

Score 2 or more

Answer 11

anticoagulation required with vitamin K antagonist like warfarin within therapeutic range (INR 2–3) or a DOAC (rivaroxaban, apixaban).

Question 12

If already on anticoagulant

Answer 12

Manage modifiable risk factors for bleeding (HAS BLED – uncontrolled HTN, renal/liver disease, labile INR, using NSAIDs/antiplatelets, alcohol consumption).

Question 13

General lifestyle advice

Answer 13

• Avoid alcohol.
• Smoking cessation.
• Healthy diet.
• Exercise.

Question 14

Warfarin advice

Answer 14

• Needs INR check.
• Teratogenic.
• Can interfere with other medications.
• Increased bleeding risk.
• Diet control.
• Can be reversed with vitamin K.

Question 15

DOAC advice

Answer 15

• Non-reversible.
• Increased bleeding risk.
• Expensive.
• C/I in renal impairment/Hx of GI bleed.