Chadvs score and hereditary conditions

[mjm1971]

Can someone explain why there is no points added if someone in your family has had a stroke when doing the score

My mum had a TIA aged 59 then she was diagnosed with AFIB and had 8 years battling AFIB as she was very symptomatic she went onto thinners as well but still had a stroke at 67 , she never smoked or drank and was fit for her age .

Yet I’m aged 50 have part time AFIB and have a score of 0 in regards risk of stroke

I just find it odd that close family history is not taken into account and your not given a point on the scores as precaution at least having a close family member who had a stroke etc .

I appreciate my mums score would have been around 4 when she had the stroke due to her being female aged 67 and already had a TIA and had AFIB .

Just curious if anyone knows why they seem to ignore family history to a degree

[jeanjeannie50]

That's a really good point. I don't know the answer, but will be interested to see the replies you get.

[Physalis]

I think that the score just covers the main problems that are likely to make you more likely to have a stroke. It can't cover every eventuality.

[mjm1971 in reply to Physalis]

I get that it can’t cover everything but I would have thought hereditary issues would be important 🤷‍♂️

[Hidden]

I don’t know the answer either but we are told that CHADs is not a precise science and is therefore more of an informed guide than something set in stone…..

[mjm1971 in reply to Hidden]

Hi Flapjack , I’ve told 2 doctors and 2 cardiologists re my mothers history and it didn’t change any of their minds re my stroke risk and thinners . I will ask them why next time I see mine on Thursday and see what he says .

[Physalis in reply to mjm1971]

Was your mother's stroke caused by a clot or a bleed. If it was a bleed then anti coagulants could make it worse.

Google says "Family history – stroke is not hereditary, but if a close family member has had a stroke some of the risk factors may be hereditary such as high blood pressure, diabetes or abnormally high cholesterol."

However, the stroke website says "If a close relative (parent, grandparent, brother or sister) has had a stroke, your risk is likely to be higher. Speak to your GP if you have close relatives with stroke or heart attack, as some kinds of high cholesterol can run in families."

Actually, they are saying the same thing. Maybe you could ask your doctor to check to see if you have high cholesterol.

[mjm1971 in reply to Physalis]

Hi physalis, she had clots in her neck that caused the stroke . She had no other issues other than AFIB and a previous TIA .

Never drank or smoked , ate healthily walked miles .

I have no other issues other than Part Time AFIB hence my score of 0

[Physalis in reply to mjm1971]

So the clots in her neck could have been caused by high cholesterol or furred up arteries.

[mjm1971 in reply to Physalis]

Cholesterol all ok , no idea if furred up but never smoked or drank and was fit for age

[Elephantlydia]

A very good question,and I do not know the answer,perhaps this should be in the equation.

[CDreamer]

My understanding is that CHADSVASC is purely a guide for clinicians and there are many I have met, some who spoke at the Patient Days, who would advise that all people with AF would benefit from prophalactic anticoagulation. I know both my GP and EP wanted me on anticoagulation when diagnosed aged 57, fit healthy and no other conditions at that time, it was I who said no, not yet.

I believe it’s not set in stone so you can request them. Maybe ring the AFA and ask for advice?

[mjm1971 in reply to CDreamer]

With all the stats out there , I can’t find 1 that shows how many AFIB patients who had a stroke had no other issues at the time ?

[CDreamer in reply to mjm1971]

Neither can I, and believe me I have looked!

One of the most impressive studies I read was the AFA supporter GP Dr Matthew Fay, a GP in Yorkshire who through a retrospective study looked at the number of AF patients in his own practice who anticoagulated who then went on to suffer strokes with a neighbouring practice where anticoagulation was not prescribed for AF patients and the people who suffered strokes was high. I can’t remember the numbers and I can no longer find the study. There were figures in a study aimed at Houses of Parliament in 2018 but I think I cleared out my copy.

Quick look in the AFA archives didn’t reveal much but worth taking a look at the GRASP tool which I think Dr Fay helped develop.

heartrhythmalliance.org/afa...

[CDreamer in reply to mjm1971]

Ahh… found it - here you go - heartrhythmalliance.org/fil...

[Jetcat]

Interesting point mjm. I will also be interested to see any answers. I personally find it strange that especially a close family members history with the same issue isn’t taken into account. Or do they just work off our own personal stats.?

[Hidden]

Hi mjm1971,

There is nothing conclusive about genetics. Fer instance, my paternal grandfather died from a series of strokes over a period of time in 1964 aged 82. Don't know if AF was a documented medical condition then. My 2nd cousin (if I have it right) had AF - he was a son of my grandfathers brother. I have AF, my daughter when aged in her early thirties had two daughters over a couple of years, each time she developed AF. My parents died from non cardiac medical conditions, my Dad had diabetes, my mother dementia.

So to the best of my knowledge AF doesn't have the same genetic ring to it that diabetes does.

John

[tunybgur]

I don't think there is a strong hereditary link to having a stroke, however some of the contributory factors can be inherited....high blood pressure, stress etc.

[Nigel2000]

Good question! Impossible for me to get clear answer from my docs.