CHA₂DS₂-VA Score Calculator
Estimate the stroke risk of someone with atrial fibrillation using the CHA₂DS₂-VA score — the version introduced by the 2024 European Society of Cardiology guidelines, which drops the sex category from the older CHA₂DS₂-VASc. Each risk factor adds points; most add one, while age ≥75 and a prior stroke add two. Tick the factors that apply to get the score and the guideline recommendation on anticoagulation.
How the score adds up
C — CHF/LV dysfunction (1), H — hypertension (1), A₂ — age ≥75 (2), D — diabetes (1), S₂ — prior stroke/TIA/thromboembolism (2), V — vascular disease (1), A — age 65–74 (1). Maximum 8. CHA₂DS₂-VA drops the female-sex “Sc” point of the older CHA₂DS₂-VASc. Source: 2024 ESC Guidelines for the management of atrial fibrillation, European Heart Journal 2024.
Frequently asked questions
What is the CHA₂DS₂-VA score?
CHA₂DS₂-VA is the stroke-risk score for atrial fibrillation recommended by the 2024 European Society of Cardiology (ESC) guidelines. It is the familiar CHA₂DS₂-VASc score with the final “Sc” — female sex category — removed, so the maximum falls from 9 to 8. The letters stand for Congestive heart failure, Hypertension, Age ≥75 (2 points), Diabetes, prior Stroke/TIA/thromboembolism (2 points), Vascular disease and Age 65–74.
Why did the 2024 guidelines drop sex from the score?
The ESC concluded that including sex complicated clinical practice and that stroke risk in atrial fibrillation is better viewed as sex-neutral, with sex acting as a risk modifier rather than an independent factor. Removing it gives men and women the same thresholds and simplifies decision-making, while keeping essentially the same ability to identify people at genuinely low risk who do not need anticoagulation. Dropping the “Sc” category also lowers the maximum total from 9 to 8, so the two scores are not interchangeable for a woman with risk factors. Sex still matters clinically — it is weighed as a modifier of risk during the assessment — but it no longer moves the anticoagulation threshold.
What score means anticoagulation is recommended?
Under the 2024 ESC guidance, oral anticoagulation is recommended (Class I) at a CHA₂DS₂-VA score of 2 or more, should be considered (Class IIa) at a score of 1, and is not recommended at a score of 0. The same thresholds apply regardless of sex. The final decision still weighs bleeding risk, patient preference and the type of atrial fibrillation.
How is each point counted?
Add one point each for congestive heart failure or LV dysfunction, hypertension, diabetes, vascular disease (prior MI, peripheral artery disease or aortic plaque) and age 65–74; add two points for age ≥75 and for a prior stroke, TIA or systemic thromboembolism. Age is counted once — two points at 75 and over, one point at 65–74, or none below 65. The total ranges from 0 to 8.
When should the score not be used?
CHA₂DS₂-VA is for non-valvular atrial fibrillation. It does not apply to valvular AF (moderate-to-severe mitral stenosis or a mechanical heart valve), where anticoagulation is indicated regardless of the score, and it does not capture bleeding risk — clinicians weigh that separately, correcting modifiable bleeding factors rather than withholding anticoagulation. This calculator is an educational reference, not medical advice.
This is a reference tool, not a diagnosis or medical advice. Results depend on the laboratory, assay and clinical context, and reference intervals vary between labs and by age and sex — always read your result against the range printed on your own report and discuss it with a qualified healthcare professional.
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