CHADSVASC score for Atrial fibrillation and Flutter – Dr Jamal USMLE

CHADSVASC score for Atrial fibrillation and Flutter – Dr Jamal USMLE


okay so today we’ll be talking about the
ChadVASC score when do we use the Chadsvasc scor,e basically this is a
score that was developed to know whether a patient has a higher risk of having
strokes in afib or atrial flutter, they basically took a bunch of patients you
can say like a hundred thousand patients and they have stratified them according
to the risks and then they followed them for a couple of years and they said okay
it seems that the patient with the higher risks had more chance of getting
a stroke every year so they developed the score but the score was not really
ChadsVasc we had the previous score which was called CHADS which only had
five categories and according to that you will say whether
your patient was high-risk or not but the newer modified version is actually
called CHADSVASC. let’s go through that really quickly the C stands for CHF
heart failure, H stands for hypertension, A with the two you gotta remember that
if your patient is above seventy five is 75 is gonna get two points, d guess what
diabetes, the S stands for stroke and if your patient had a stroke or a TIA then
they will get two points, V stands for vascular disease so if if your patient
has peripheral vascular disease coronary artery disease; aortic, peripheral
any of that they’ll get a point now the second a as you remember we had an A that had two points but this a actually means that if your patient is
between 65 and 74 they will get one point,
above or equal 75 they’ll get two points and now the S and C at the end stands for the sex your patient is a female automatically
she will get one point so all of those they get one point except if you have a
history of stroke you’ll get two points or if your patient is above or equals 75
years of age they will get two points each but the rest will get one point. now things that you know you just have to
think about. if you have a female and she is 76 years old even without knowing
what her medical comorbidities are; she’s gonna get two points and one point she’s
gonna get three points by itself according to the CHADSVASC she
needs anticoagulation just think about it.
now how do I choose whether the patient needs anticoagulation or not. so if
they’re CHADSVASC is zero do nothing and do not harm the patient. if a patient
has a score of one; recently they said as pirin would work. if the patient has two
or more then you will need anti-coagulation and basically we’re talking about Full anticoagulation. your options are warfarin or any of those
newer oral anticoagulants if the patient is in the hospital
you give them heparin drip or you can put them on lovenox
and that’s basically the CHADSVASC score whenever you get a question
in your exam saying this patient has atrial fibrillation or atrial flutter
how can I prevent them from having a stroke; first you have to ask yourself
what is their CHADSVASC score, zero then do nothing, one you can give them
aspirin but if they have two or more points then you will deem them for
anticoagulation for the rest of their lives

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