## CHA₂DS₂-VASc Score for Stroke Risk in Atrial Fibrillation **Key Point:** The CHA₂DS₂-VASc score stratifies stroke risk in AF patients and guides anticoagulation decisions. Each component carries a specific point value. ### CHA₂DS₂-VASc Scoring System | Component | Points | |-----------|--------| | **C**ongestive heart failure (or LVEF ≤40%) | 1 | | **H**ypertension (on treatment or BP ≥140/90) | 1 | | **A**ge ≥75 years | **2** | | **D**iabetes mellitus | 1 | | **S**troke/TIA/thromboembolism (prior) | 2 | | **V**ascular disease (MI, PAD, aortic plaque) | 1 | | **A**ge 65–74 years | 1 | | **Sc**ex category (female) | 1 | **High-Yield:** Two components carry 2 points each: 1. **Age ≥75 years** (2 points) 2. **Prior stroke/TIA/thromboembolism** (2 points) All other components carry 1 point each. **Mnemonic:** CHA₂DS₂-VASc — The **subscript 2** appears twice in the acronym itself, representing the two variables worth 2 points: age ≥75 and prior stroke. **Clinical Pearl:** A CHA₂DS₂-VASc score of 0 in males (or ≥1 in females) warrants anticoagulation. Score of 1 in males may be managed with aspirin or anticoagulation depending on bleeding risk and clinical judgment. **Warning:** Do not confuse CHA₂DS₂-VASc (stroke risk) with HAS-BLED (bleeding risk); they are complementary but distinct tools.
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