CVA on ASA means a person has had a cerebrovascular accident (CVA), commonly called a stroke, and is taking ASA, which means acetylsalicylic acid (aspirin).

Aspirin is an antiplatelet medicine often used to reduce the chance of another ischemic stroke by preventing platelet clots. It is not generally used to treat a hemorrhagic (bleeding) stroke. The appropriate treatment depends on the stroke type and cause. The American Stroke Association guidance lists aspirin or another antiplatelet option for many patients after non-cardioembolic ischemic stroke or TIA.

If PR = per rectum, then yes, aspirin may still be prescribed PR when a patient with prior CVA is already “on ASA” but cannot safely swallow, such as during an acute stroke assessment with dysphagia.

Key distinction:

For suspected acute stroke, aspirin should only be given after brain imaging has excluded intracranial hemorrhage, unless the treating stroke team has directed otherwise. It is also usually delayed for at least 24 hours after thrombolysis, until repeat imaging excludes bleeding. A stroke acute-care guideline specifies rectal or enteral aspirin for dysphagic patients with disabling ischemic stroke.

So: history of CVA and already on aspirin does not itself prevent prescribing PR aspirin, but the prescriber must confirm this is an ischemic stroke scenario and avoid unintended excess dosing.