CHA₂DS₂-VASc Score & Anticoagulation

By behereaxum

Summary

Atrial fibrillation and flutter let blood pool and clot, raising stroke risk. CHA2DS2-VASc tells us who needs anticoagulation.

Chapters

  1. Atrial fibrillation and flutter let blood (0s)
  2. Score each factor: Congestive heart failure, (8s)
  3. Take a seventy-eight-year-old woman with hypertension (21s)
  4. A score of zero in men, (29s)
  5. First-line is a direct oral anticoagulant. (36s)
  6. But weigh the bleeding risk: active (43s)
  7. Monitor renal function on DOACs, and (50s)

Transcript

Atrial fibrillation and flutter let blood pool and clot, raising stroke risk. CHA2DS2-VASc tells us who needs anticoagulation. Score each factor: Congestive heart failure, Hypertension, Age seventy-five plus counts two, Diabetes, prior Stroke counts two, Vascular disease, Age sixty-five to seventy-four, and female Sex. Take a seventy-eight-year-old woman with hypertension and diabetes: age two, hypertension one, diabetes one, sex one, a total of five. A score of zero in men, or one in women, needs nothing. Two or more means anticoagulate. First-line is a direct oral anticoagulant. Warfarin stays reserved for mechanical valves or significant mitral stenosis. But weigh the bleeding risk: active bleeding, severe liver disease, or recent hemorrhage are contraindications. Monitor renal function on DOACs, and INR on warfarin. Same rules for both fibrillation and flutter.