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Act FAST in cases of stroke

May 16, 2013

Do you have high blood pressure, high cholesterol, heart disease or diabetes? Do you smoke? If you answered “yes” to any of these questions, you’re at risk for stroke.

Each year about 795,000 Americans suffer a new or recurrent stroke. Stroke kills more than 137,000 people a year.

Stroke is the 4th leading cause of death and the leading cause of disability in this country, and the 3rd leading cause of death in WI. Annually, Americans pay more than $73 billion for stroke-related medical costs and disability.

About 40 percent of stroke deaths occur in males and 60 percent occur in females. About every 40 seconds someone suffers a stroke and more than 77 percent are first events.

There are different types of strokes, including “ischemic” strokes, which are the most common. Blood vessels are narrowed or blocked by fatty plaque that forms, or by clots that travel through the bloodstream. Like a heart attack, when the heart muscle doesn’t get enough blood and oxygen, an ischemic stroke is called a “brain attack.”

The American Stroke / American Heart Association recommends that hospitals provide an intravenous “clot busting” drug called tissue plasminogen activator (t-PA) to eligible patients with acute ischemic stroke in a timely fashion.

tPA has been shown to actually stop, and in some cases, even reverse the progression of a stroke. This drug needs to be given in a short time-frame and the closer to onset of symptoms the more effective the medication is.

This drug may not be appropriate for patients who have been taking blood thinners or who have poorly controlled high blood pressure.

In the emergency department, a person experiencing stroke symptoms will be examined and diagnostic tests will be performed. These tests can determine if a transient ischemic attack (TIA), stroke or another medical problem caused the symptoms. Depending on the outcome of the tests, the patient’s medical history and physical condition, a medical course of action will be determined.

A TIA is a “mini-stroke” having the same signs as a stroke; only the symptoms last a few minutes to hours. Only about 10 percent of strokes are preceded by a TIA. However, a person who’s had at least one TIA is about nine times more likely to have a full blown stroke than someone of the same age and sex who hasn’t. TIAs are extremely important warning signs for stroke that cannot be ignored.

The following guidelines from the American Heart Association and the American Stroke Association offer advice for preventing stroke and responding immediately if someone shows signs of stroke.

To reduce the incidence of stroke, it’s important for all adults to be screened for high blood pressure, high cholesterol and diabetes. It’s essential that if you smoke you take the steps to quit. You can help prevent a stroke by identifying and controlling your risk factors.

Signs and Symptoms of Stroke - Remember the acronym FAST:

F = Face: Ask the person to smile. Does one side of the face droop?
A = Arms: Ask the person to raise both arms. Does one arm drift downward?
S = Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
T = Time: If you observe any of these signs, call 9-1-1 immediately.

Calling 9-1-1 usually results in faster treatment than driving someone to the Emergency Department. If any of these symptoms occur, you need to act FAST. Don’t wait!

The key to successfully treating strokes is to educate people to recognize the signs and symptoms and have them understand the importance of acting quickly, even if the symptoms disappear within a few minutes.

In stroke cases, “time is brain” and, generally, the sooner the clot busting medication is given, the better the outcome.

Dr. Elizabeth Marriott is a neurologist who practices at Aurora St. Luke’s Medical Center and can be reached at 414 385-1801

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