Learn About Your Heart...
Made Simple

By Nicolas Shammas, MD

A new, comprehensive sourcebook for
heart and vascular disease patients

Cardiovascular Health Topics

Statistics about Heart and Blood Vessel Diseases in the United States
Structure and Function of the Heart and Blood Vessels
Diseases of the Blood Vessels of the Heart
Surgical Therapies for the Cardiovascular Patient
Peripheral Vascular Disease
Diseases of the Blood Vessels of the Head and Neck
Strokes: How to Survive Them and How to Prevent Them
Valvular Heart Disease
Heart Rhythms: How to Recognize Them and Treat Them
Congestive Heart Failure
11. Understanding Cardiomyopathy, or Weak Heart Muscle
12. Children and Heart Disease
13. Diseases of the Pericardium
14. Systemic Illnesses, Infections and Drugs that Affect the Heart
15. Erectile Dysfunction: a Vascular Disease
16. Cardiovascular Disease Prevention
17. Heart Healthy Nutritional Tips
18. Cardiac Rehabilitation
19. Medications for Cardiovascular Disorders
20. Heart Tests You Need to Know
21. Learn What to Do in a Medical Emergency
22. How to Choose Your Doctor and Hospital
23. Medical Research and How You Can Get Involved
24. Taking the Next Step — A Few Community Resources to Help You Live More Healthfully
25. How Much Did You Learn from This Book: Take a Simple Test

Know the warning signs of stroke

The American Stroke Association wants you to learn the warning signs of a stroke. If you notice 1 or more of these signs, DON'T WAIT. CALL 9-1-1 and get to the hospital immediately!

Warning signs of a stroke include:

  • Sudden numbness or weakness of the face, arm, or leg, especially on 1 side of the body

  • Sudden confusion, trouble speaking, or understanding

  • Sudden visual problems, double vision, or sudden loss of vision

    Sudden trouble walking, dizziness, loss of balance, or coordination

  • Sudden, severe headache with no known cause.

Take action if you suspect a stroke

  • Not all the warning signs occur in every stroke. Don't ignore signs of stroke, even if they go away!

  • Check the time. When did the first warning sign or symptom start? You'll be asked this important question later.

  • If you have 1 or more stroke symptoms that last more that a few minutes, don't delay! Immediately call 9-1-1 or the emergency medical service number so an ambulance can quickly respond.

  • If you're with someone who may be having stroke symptoms, call 9-1-1. Expect the person to protest; denial is common. Don't take "no" for an answer. Insist on taking action!

How do I know if I have had a stroke?

Anyone who may be having a stroke should go to an emergency center immediately. The doctors will get a medical history from you. If you or the person who is experiencing symptoms is unable to give a history, others who know the patient will be asked to assist. A neurologist—a doctor specializing in the nervous system and brain disorders—will be called to assist in the diagnosis and management of the stroke patient.

A CT (computed tomography) scan will be ordered. A CT scan—a special x-ray of the brain—will show bleeding into the brain, which will be treated differently than a stroke caused from a blocked artery.

A MRI (magnetic resonance imaging) scan is another method of viewing the brain. Although the MRI scan is able be get much more detailed pictures of the brain, the CT scan is the first procedure preformed.

The conventional angiogram is another test that can be performed to view the blood vessels, carotid arteries, and the brain.

Carotid ultrasound is a noninvasive test that uses sound waves to detect narrowing and a slowing or reduction in blood flow through the carotid arteries.

Echocardiogram is a test to evaluate the function of the heart. This test is done on stroke patients in search of the source of an embolism.

Electrocardiogram (EKG or ECG) is a test that can be done to check your heart rhythm. An irregular heartbeat can be a source of an embolism that can cause a stroke.

Treatment options for stroke

Tissue plasminogen activator (TPA) is a new medication developed during the last few years for immediate treatment of stroke. TPA is a clot-buster medication if given within the first 3 hours of the onset of symptoms through an I.V. It has been shown to improve the patient's long-term outcome from a stroke. The 3-hour timeframe is critical and, again, is why you need to seek help immediately.

Medications like aspirin and heparin (antiplatelets), which are used to thin the blood, sometimes are used to treat patients in hopes of improving the patient's recovery from a stroke. It is not clear if this improves the stroke or if it helps to prevent more strokes. If a patient is unable to take aspirin, new antiplatelet medications, such as clopidogrel (Plavix) and ticlopidine (Ticlid), are available.

Medical procedures to prevent a stroke

Carotid endarterectomy is an operation that cleans out the plaque causing the narrowing or ulceration of the carotid artery.

In carotid stenting a stent (metal tube) is inserted into the carotid artery to open the narrowing or ulceration and stabilize the carotid artery.These procedures are explained in more detail in Chapter 6.

Rehabilitation—How to recuperate from a stroke

After a stroke, the affected area of the brain dies and probably will not recover its function. When a patient has stabilized after a stroke, the focus begins on rehabilitation. The goal is to maximize the patient's recovery to be able to return to his or her normal daily activities. Therapies available include speech therapy, to help the patient to learn to eat and speak again; occupational therapy, to help the patient relearn the use of his or her arms and hands; and physical therapy, to help the patient regain strength and possibly regain the ability to walk.

Although the goal is to help the person regain the ability to engage in former daily activities, this is usually not realistic. The patient and family members will also be educated on how to adjust to these changes in life and to live as full a life as possible.

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