Atrial Fibrillation (AF) Lecture Notes For Healthcare Professionals


CHA2DS2 VASc score:

  • It’s a score used to determine the need for antiplatelet or anticoagulant or neither as a prophylaxis against embolic events, especially ischemic strokes in patients with Atrial Fibrillation (AF).
  • Every letter is indicating a risk factor that contributes to the score:
    • The C stands for Congestive Heart Failure (CHF) or Ejection Fraction (EF) equal to or less than 40%, and the presence of either is scored (1).
    • H for hypertension scored (1).
    • A2 stands for an age of 75years or older, and adds (2) to the score.
    • The D means diabetes mellitus, as its presence is scored (1).
    • S2 it means adding (2) to the score in case of a previous history of Transient Ischemic Attack (TIA), Ischemic stroke, or a thromboembolic event.
    • V is referring to vascular disease if present you should add (1) to the score.
    • The second A is for adding (1) to the score if the patient’s age is between 65 and 74 years.
    • Last but not least Sc is indicating adding (1) to the score in case of female sex.
  • if the CHA2DS2 VASc score is
    • (0), no prophylaxis is preferred over ASPIRIN.
    • (1), ASPIRIN is preferred over anticoagulants like Vitamin K Antagonist (VKA), or the Direct Oral AntiCoagulants (DOAC).
    • 2 or more, anticoagulants are preferred if not contraindicated.


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