Cardiovascular Medicine Book

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CHAD ScoreAka: CHADS Score, CHADS2

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  1. Indication
    1. Assess Risk of stroke with Atrial Fibrillation
  2. Criteria (mnemonic: CHADS)
    1. Congestive Heart Failure (1 point)
      1. Relative risk of Stroke or TIA: 1.4
    2. Hypertension (1 point)
      1. Relative risk of Stroke or TIA: 1.6
    3. Age over 75 years (1 point)
      1. Relative risk of Stroke or TIA: 1.4
    4. Diabetes Mellitus (1 point)
      1. Relative risk of Stroke or TIA: 1.7
    5. Stroke or TIA history (2 points)
      1. Mitral Stenosis or prosthetic heart valve carry similar risk and also indicate Warfarin
      2. Relative risk of Stroke or TIA: 2.5
  3. Interpretation
    1. CHADS Score >2 (CVA risk >5% per year): Warfarin with goal INR 2.0 to 3.0
    2. CHADS Score >1 (CVA risk >4% per year): Warfarin or Aspirin
    3. CHADS Score 0: Aspirin 81 to 325 mg daily
  4. References
    1. Gage (2004) Circulation 110:2287

Atrial Fibrillation (C0004238)

Definition (MSH)Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation.
Definition (CSP)disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions.
Definition (NCI)An arrhythmia in which minute areas of the atrial myocardium are in various uncoordinated stages of depolarization and repolarization; instead of intermittently contracting, the atria quiver continuously in a chaotic pattern, causing a totally irregular, often rapid ventricular rate.
Definition (NCI)A supraventricular arrhythmia characterized by uncoordinated atrial myocardium activation due to multiple reentry circuits with consequent deterioration of atrial mechanical function. Instead of intermittently contracting, the atria quiver continuously in a chaotic pattern, causing a totally irregular, often tachycardia ventricular rate. On the ECG it is described by the replacement of consistent P waves by rapid oscillations or fibrillatory waves that vary in size, shape, and timing, associated with an irregular, frequently rapid ventricular response when atrioventricular conduction is intact.
ConceptsPathologic Function (T046)
ICD9427.31
MSHD001281
EnglishAF, AF - Atrial fibrillation, AFib, Atrial Fibrillation, Atrial Fibrillations, Auricular Fibrillation, Auricular Fibrillations, Fibrillation - atrial, FIBRILLATION ATRIAL
Spanishfibrilacion auricular
Parent ConceptsFibrillation (C0232197), cardiac arrhythmia (C0003811), Atrial fibrillation and flutter NOS (C0155709), Supraventricular arrhythmia (C0428974), Atrial arrhythmia (C0085611)
SourcesAOD, CCS, COSTAR, CSP, CST, DXP, ICD9CM, LCH, MEDLINEPLUS, MSH, MTH, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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