Cardiology
General medicine
The CHA₂DS₂-VA is the score recommended by the 2024 ESC guidelines to structure the assessment of the risk of stroke and thromboembolism in patients presenting with clinical atrial fibrillation. It incorporates the core components of the historical CHA₂DS₂-VASc, but without assigning points for female sex. It is a risk stratification tool: it does not diagnose atrial fibrillation and does not, on its own, constitute a prescription for anticoagulants.
Number of questions
6 sets of criteria
Approximate duration
≈ 1 minute
Population
adults with clinical atrial fibrillation
Modality
calculated by a professional based on age and history
QuestionnaireCHA₂DS₂-VA
CLINICIAN SCORE
The two age categories are mutually exclusive. A 78-year-old patient receives 2 points for age, not 3.
Are you patient?
This score is intended to be calculated and interpreted by a healthcare professional. However, you can review the factors considered and discuss them with your doctor. Do not start, stop, or change an anticoagulant based on an online calculation.
Terms of contract
The score applies after clinical atrial fibrillation has been identified. Medical history must be confirmed through patient interview and records. The risk changes with age and the emergence of new factors: regular re-evaluation is necessary. This score is recommended by the 2024 ESC guidelines for thromboembolic risk stratification, particularly where no locally validated alternative exists.
Score interpretationCHA₂DS₂-VA
Sum of points for criteria present (age: 1 point between 65 and 74 years, 2 points for 75 years and older; history of stroke, TIA or thromboembolism: 2 points; other criteria: 1 point). Score from 0 to 8.
Total score
First reading
0
to
0
Low risk according to this score; no indication for anticoagulation based on this score alone.
1
to
1
Oral anticoagulation to be considered depending on the individual context.
2
to
8
Oral anticoagulation is recommended in the absence of contraindications, following clinical evaluation.
0: low risk; 1: oral anticoagulation to consider; ≥ 2: oral anticoagulation recommended in the absence of contraindications.
Do not automatically convert the total into an annual stroke percentage without citing a specific cohort: observed rates vary according to populations and management strategies.
Frequently asked questions
What does the CHA₂DS₂-VA score stand for?
What is the difference compared to CHA₂DS₂-VASc?
What are its limitations?
Sources and references
European Society of Cardiology
ESC Guidelines for the management of atrial fibrillation, 2024
In practice
Full name
CHA₂DS₂-VA — Congestive heart failure, Hypertension, Age ≥75, Diabetes mellitus, Stroke/TIA/thromboembolism, Vascular disease, Age 65–74
Method
calculated by a professional based on age and history
Language
not dependent on a patient questionnaire; clinical definitions to be documented in French
Authors
European Society of Cardiology
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