Risk Scores- CHADSVAS

Question 1

risk calculation in CHADS-VAS

Answer 1

Congestive heart failure: 1

hypertension: 1

Age >/= 75 :2

Diabetes: 1

Stroke or TIA history :2

Vascular disease : 1

Age 65-74: 1

sex female: 1

Question 2

The score of CHADSVAS with a score of 0 (male)/ 1 (female)

Answer 2

low risk

No anticoagulant therapy

Question 3

The score of CHADSVAS with a score of 1 (male)

Answer 3

moderate risk

Oral anticoagulant should be considered

with well controlled Vitamin K Antagonist

or non-VKA (NOAC: dabigatran, rivaroxaban)

Question 4

The score of CHADSVAS with a score of 2 or higher

Answer 4

high risk

Oral anticoagulant is recommended

Question 5

CHADSVAS for those already on anticoagulants?

Answer 5

manage modifiable risk factors for bleeding (HAS-BLED score, uncontrolled HTN, concurrent use of aspirin or NASID, alcohol consumption)

For those in warfrin assess anticoagulanion control

for those on NOAC: apixaban, dabigatran, rivaroxaban)

Question 6

what lifestyle advice?

Answer 6

avoid alcohol, smoking, healthy diet, excerise

Question 7

cons of warfrin

Answer 7

daily INR

tetratogenic, can interfer with other medications, increa bleeding risk, diet control, reversible with Vit K

Question 8

Cons of NOACs

Answer 8

non reversible

increaded bleeding risk

expensive

contrainindicated with renal failure and history of GI bleed