What does CHA2DS2-VASc stand for?

C = Congestive heart failure, H = Hypertension, A2 = Age 75 or older (2 points), D = Diabetes mellitus, S2 = prior Stroke/TIA/thromboembolism (2 points), V = Vascular disease, A = Age 65-74, Sc = Sex category (female).

What score threshold indicates anticoagulation?

Guidelines generally recommend anticoagulation for scores >=2 in men and >=3 in women. A score of 1 in men or 2 in women represents intermediate risk where therapy may be considered.

Does this tool apply to valvular atrial fibrillation?

No. CHA2DS2-VASc was validated for non-valvular AF. Patients with rheumatic mitral stenosis or mechanical heart valves have a different risk profile and require separate assessment.

Is the estimated stroke rate exact?

The annual stroke rates shown are population-level estimates derived from validation studies. Individual patient risk depends on many additional factors. Always defer to a qualified clinician for treatment decisions.

What is the maximum possible score?

The maximum CHA2DS2-VASc score is 9, achieved when all eight risk factors are present (age 75+ contributing 2 points and prior stroke/TIA contributing 2 points).

CHA2DS2-VASc Stroke Risk Calculator

Calculate the CHA2DS2-VASc score to estimate stroke risk in patients with non-valvular atrial fibrillation and see the recommended management guidance.

Risk Factors

Select all criteria that apply to the patient.

Congestive Heart Failure +1 pt

Signs/symptoms of heart failure or objective evidence of reduced left ventricular ejection fraction.

Hypertension +1 pt

Resting blood pressure consistently above 140/90 mmHg or on antihypertensive treatment.

Age 75 Years or Older +2 pts

Patient is aged 75 or above. This criterion awards 2 points and takes priority over the age 65-74 criterion.

Diabetes Mellitus +1 pt

Fasting glucose over 125 mg/dL or treatment with an oral hypoglycemic agent or insulin.

Prior Stroke / TIA / Thromboembolism +2 pts

History of stroke, transient ischemic attack, or systemic thromboembolism.

Vascular Disease +1 pt

Prior myocardial infarction, peripheral arterial disease, or aortic plaque.

Age 65 to 74 Years +1 pt

Patient is aged 65-74. Mutually exclusive with the age 75+ criterion — select only one age category.

Female Sex +1 pt

Biological female sex. Note: female sex alone (score = 1) is not considered a standalone indication for anticoagulation.

Medical Disclaimer: This tool is for educational reference only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified clinician before making any clinical decisions.

0 / 9

CHA2DS2-VASc Score

Low Risk

Estimated annual stroke rate: ~0%

Clinical Guidance

Anticoagulation generally not recommended. Reassess if risk factors develop.

Score Reference Table

Score	Risk Level	Est. Annual Stroke Rate	Guidance
0	Low	~0%	No anticoagulation
1	Low-Moderate	~1.3%	Consider anticoagulation (males); reassess if female-only
2	Moderate	~2.2%	Anticoagulation recommended
3	Moderate-High	~3.2%	Anticoagulation recommended
4	High	~4.0%	Anticoagulation recommended
5	High	~6.7%	Anticoagulation recommended
6	High	~9.8%	Anticoagulation recommended
7	Very High	~9.6%	Anticoagulation strongly recommended
8	Very High	~6.7%	Anticoagulation strongly recommended
9	Very High	~15.2%	Anticoagulation strongly recommended

Summary

The CHA2DS2-VASc score is a clinical prediction tool used to estimate annual stroke risk in patients with non-valvular atrial fibrillation (AF). It evaluates eight risk factors — heart failure, hypertension, age, diabetes, prior stroke/TIA, vascular disease, and sex — to produce a score from 0 to 9. Higher scores indicate greater stroke risk and guide decisions about anticoagulation therapy.

How it works

Select each risk factor that applies to the patient from the checklist.
The calculator assigns 2 points each for age 75 or older and prior stroke/TIA/thromboembolism.
It assigns 1 point each for heart failure, hypertension, diabetes, vascular disease, age 65-74, and female sex.
The total score (0-9) maps to an estimated annual stroke risk percentage and a clinical recommendation tier.

Use cases

Estimate annual stroke risk in a patient newly diagnosed with atrial fibrillation.
Determine whether oral anticoagulation is indicated before cardioversion.
Educate patients about modifiable and non-modifiable stroke risk factors.
Support shared decision-making discussions between clinician and patient.
Quick bedside reference for AF management in emergency or outpatient settings.

Frequently Asked Questions

Last updated: 2026-09-30 · Reviewed by Nham Vu