CHAD Score

http://www.fpnotebook.com/cv/exam/ChdScr.htm

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CHAD Score
Aka: CHAD Score, CHADS Score, CHADS2 I. See Also A. Atrial Fibrillation Anticoagulation B. Outpatient Bleeding Risk Index II. Indication A. Assess Risk of stroke with Atrial Fibrillation III. Contraindications: Conditions that if present may trump the decision to anticoagulate A. Valvular heart disease B. Prior peripheral embolism C. Intracardiac thrombus D. Hyperthyroidism IV. Criteria (mnemonic: CHADS) A. Congestive Heart Failure (1 point) 1. Relative risk of Stroke or TIA: 1.4 B. Hypertension (1 point) 1. Relative risk of Stroke or TIA: 1.6 C. Age over 75 years (1 point) 1. Relative risk of Stroke or TIA: 1.4 D. Diabetes Mellitus (1 point) 1. Relative risk of Stroke or TIA: 1.7 E. 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 V. Disadvantages A. Does not account for atrial enlargement (higher risk of CVA) VI. Interpretation A. CHADS Score >2 (CVA risk >5% per year): Warfarin with goal INR 2.0 to 3.0 B. CHADS Score 1 (CV A risk >4% per year): Warfarin or Aspirin C. CHADS Score 0: Aspirin 81 to 325 mg daily VII. References A. Gage (2004) Circulation 110:2287-92

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CHAD Score

http://www.fpnotebook.com/cv/exam/ChdScr.htm

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CHADS2 Score maintained at soapnote.org. Congestive heart failure * Yes No

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Hypertension: Blood pressure consistently above 140/90 or on blood pressure medication? * Yes No Age > 75 * Yes No Diabetes mellitus * Yes No

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CHAD Score

http://www.fpnotebook.com/cv/exam/ChdScr.htm

American College of Chest Physicians (ACCP) Stroke Risk maintained at soapnote.org. History of Stroke or TIA * Yes No Hypertension * Yes No Heart failure * Yes No Age * Over 75 65 to 75 Under 65

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Atrial Fibrillation (C0004238)

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. (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. A disorder characterized by a dysrhythmia without discernible P waves and an irregular ventricular response due to multiple reentry circuits. The rhythm disturbance originates above the ventricles. rapid tremor and shake of upper chambers of the heart rapid tremor and shake of upper chambers of the heart rapid tremor and shake of upper chambers of the heart rapid tremor and shake of upper chambers of the heart rapid tremor and shake of upper chambers of the heart

Definition (NCI)

Definition (NCI)

Definition (NCI) Definition (CHV) Definition (CHV) Definition (CHV) Definition (CHV) Definition (CHV)

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CHAD Score

http://www.fpnotebook.com/cv/exam/ChdScr.htm

Definition (CHV)

rapid tremor and shake of upper chambers of the heart An arrhythmia is a problem with the speed or rhythm of the heartbeat. Atrial fibrillation (AF) is the most common type of arrhythmia. The cause is a disorder in the hearts electrical system. Often, people who have AF may not even feel symptoms. But you may feel palpitations -- an abnormal rapid heartbeat shortness of breath weakness or difficulty exercising chest pain dizziness or fainting fatigue confusion AF can lead to an increased risk of stroke. In many patients, it can also cause chest pain, heart attack, or heart failure. Doctors diagnose AF using family and medical history, a physical exam, and a test called an electrocardiogram (EKG), which looks at the electrical waves your heart makes. Treatments include medicines and procedures to restore normal rhythm. NIH: National Heart, Lung, and Blood Institute

Definition (MEDLINEPLUS)

Definition (CSP)

Definition (NCI)

Definition (MSH) Concepts MSH ICD9 ICD10 SnomedCT

English

disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. 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. 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. Pathologic Function (T046) D001281 427.31 I48.0 49436004, 155364009, 266306001 Atrial Fibrillations, Auricular Fibrillation, Auricular Fibrillations, Fibrillations, Atrial, Fibrillations, Auricular, FIBRILLATION ATRIAL, ATRIAL FIBRILLATION, AURICULAR FIBRILLATION, Auricular fibrillation, Fibrillation, Atrial, Fibrillation, Auricular, AF, atrial fibrillation, atrial fibrillation (diagnosis), a fib, af, afib, Afib, AFib, Fibrillation atrial, Atrial Fibrillation [Disease/Finding], Fibrillation;atrial, atrial fibrillation (AF), auricular fibrillations, atrial fibrillations, Atrial fibrillation, AF - Atrial

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CHAD Score

http://www.fpnotebook.com/cv/exam/ChdScr.htm

French German Portuguese

Spanish

Dutch Swedish Japanese Finnish Russian Czech Italian Croatian Polish Hungarian Sources

fibrillation, Atrial fibrillation (disorder), atrium; fibrillation, auricular; fibrillation, fibrillation; atrial or auricular, Fibrillation - atrial, Atrial Fibrillation, auricular fibrillation FIBRILLATION AURICULAIRE, FA, AFib, Fibrillation auriculaire, Fibrillation atriale VORHOFFLIMMERN, AF, Afib, Flimmern Vorhof, Herzohrflimmern, HERZVORHOFFLIMMERN, Vorhofflimmern, Aurikulres Flimmern FIBRILACAO AURICULAR, FA, FIBRILHACAO AURICULAR, Fibrilhao auricular, Fibrilao Atrial, Fibrilao Auricular FIBRILACION AURICULAR, FA, Fibrilacin atrial, Atrial fibrillation, Fibrillation atrial, AURICULAR, FIBRILACION, fibrilacin auricular (trastorno), fibrilacin auricular, Fibrilacin auricular, Fibrilacin Atrial, Fibrilacin Auricular, Fibrilacion Atrial, Fibrilacion Auricular AFib, AF, atriumfibrillatie, hartoorfibrilleren, atrium; fibrilleren, auriculair; fibrilleren, fibrilleren; atrium of auriculair, atriale fibrillatie, Atriumfibrillatie, Boezemfibrillatie, Fibrillatie, atrium-, Fibrillatie, boezem-, Fibrilleren, boezemFrmaksflimmer , , Eteisvrin USHKA PREDSERDIIA FIBRILLIATSIIA, PREDSERDII FIBRILLIATSIIA, , Fibrilace ouka, Fibrilace sn, fibrilace sn, sov fibrilace, FiS Fibrillazione auricolare, Fibrillazione atriale ATRIJ, FIBRILACIJA Migotanie przedsionkw AFib, Fibrillatio atrialis, Pitvarfibrillatio
Derived from the NIH UMLS (Unified Medical Language System)

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