CHA2DS2-VASc Calculator: Stroke Risk in Atrial Fibrillation
Check what applies and get the score, the risk category, and the anticoagulation decision framework that follows from it.
Using the score honestly
The decision framework in wide use: a score of 0 in a man or 1 in a woman is low risk and anticoagulation is generally not recommended. A 1 in a man or 2 in a woman is intermediate: anticoagulation is reasonable to consider, and the conversation with the patient matters. At 2 or more in a man, or 3 or more in a woman, oral anticoagulation is recommended, and a DOAC is generally preferred over warfarin when there is no mechanical valve or significant mitral stenosis.
Two traps. First, the sex category point only matters in the presence of other risk factors, which is exactly why the thresholds differ by sex rather than the score simply being higher for women. Second, the score estimates stroke risk, not bleeding risk: the decision is a two-sided ledger, and the bleeding side has its own tools. If the answer is warfarin, dosing and reversal live in the warfarin guide; rate and rhythm decisions around new atrial fibrillation are in common night calls and the cardiology rotation guide.
This is not medical advice. Educational tool. The anticoagulation decision also weighs bleeding risk, patient values and comorbidity. Institutional protocol and current references govern.