CHA2DS2-VASc Score Calculator

Calculate the CHA2DS2-VASc score to assess stroke risk in atrial fibrillation patients. Check the boxes for each applicable risk factor — congestive heart failure, hypertension, age ≥75, diabetes mellitus, prior stroke/TIA, vascular disease, age 65–74, and female sex — and get your total score, annual stroke risk percentage, and a treatment recommendation based on current guidelines.

Disclaimer: This tool is for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making any health-related decisions.

History of congestive heart failure or left ventricular dysfunction (EF <40%). Scores 1 point.

Resting blood pressure >140/90 mmHg on at least 2 occasions, or current antihypertensive treatment. Scores 1 point.

Patient is 75 years of age or older. Scores 2 points.

Fasting glucose >125 mg/dL or treatment with oral hypoglycemic agents and/or insulin. Scores 1 point.

History of stroke, transient ischemic attack, or systemic thromboembolism. Scores 2 points.

Prior myocardial infarction, peripheral artery disease, or aortic plaque. Scores 1 point.

Patient is between 65 and 74 years of age. Scores 1 point. Select only one age category.

Patient is female. Scores 1 point. Note: female sex alone (score = 1) does not independently warrant anticoagulation.

Results

CHA2DS2-VASc Score

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Estimated Annual Stroke Risk

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Risk Category

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Treatment Recommendation

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Results Table

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Frequently Asked Questions

What does the CHA2DS2-VASc score stand for?

Each letter represents a stroke risk factor: C = Congestive heart failure, H = Hypertension, A2 = Age ≥75 (2 points), D = Diabetes mellitus, S2 = prior Stroke/TIA/thromboembolism (2 points), V = Vascular disease, A = Age 65–74, Sc = Sex category (female). The maximum possible score is 9.

What is a high CHA2DS2-VASc score?

A score of 2 or more in males, or 3 or more in females, is generally considered high risk and oral anticoagulation therapy is recommended. Scores of 0 (male) or 1 (female) indicate low risk where anticoagulation is typically not needed.

Why does female sex score a point but not always require anticoagulation?

Female sex is a risk modifier rather than an independent stroke risk factor. A score of 1 in a female patient (due solely to sex) does not on its own warrant anticoagulation. Anticoagulation for females is generally recommended when their score reaches 3 or higher, reflecting at least one additional clinical risk factor.

What is the difference between the CHA2DS2-VASc and the older CHADS2 score?

The CHA2DS2-VASc score is an extension of the original CHADS2 score and adds vascular disease, age 65–74, and female sex as additional risk factors. It more accurately identifies truly low-risk patients who do not require anticoagulation and better stratifies intermediate-risk patients compared to CHADS2.

Which anticoagulants are typically recommended based on the CHA2DS2-VASc score?

For patients with a score indicating anticoagulation, direct oral anticoagulants (DOACs) such as apixaban, rivaroxaban, dabigatran, or edoxaban are generally preferred over warfarin in non-valvular atrial fibrillation. Antiplatelet therapy alone is not recommended as an alternative to anticoagulation for stroke prevention in AF.

Does the CHA2DS2-VASc score apply to all types of atrial fibrillation?

The CHA2DS2-VASc score is validated for use in non-valvular atrial fibrillation. Patients with valvular AF (e.g., moderate-to-severe mitral stenosis or mechanical heart valves) are already considered high risk and require anticoagulation regardless of their score.

What are the limitations of the CHA2DS2-VASc score?

The CHA2DS2-VASc score provides an estimate of stroke risk but does not account for all individual patient variables such as renal function, bleeding risk (assessed separately with tools like HAS-BLED), or medication adherence. Clinical judgment should always complement score-based guidance when making anticoagulation decisions.

Can a patient have a CHA2DS2-VASc score greater than 9?

No. The maximum possible CHA2DS2-VASc score is 9, achieved when all risk criteria are present. However, only one age category (either ≥75 years or 65–74 years) should be selected at a time, as they are mutually exclusive.