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Drs. Iyengar and Zacharias on Reducing Your Stroke Risk

Drs. Iyengar and Zacharias on Reducing Your Stroke Risk

Strokes strike nearly 800,000 Americans each year, killing about 140,000 and forever changing the lives of those who survive.

In honor of National Stroke Awareness Month, BCH hosted a free health lecture in Erie, Colo. BCH interventional cardiologist Srini Iyengar, MD, and neurologist Alan Zacharias, MD, described the causes of stroke, warning signs and ways to lower your risk.

What is a Stroke?
“A stroke occurs when there’s a loss of blood flow to brain tissue, depriving brain tissue of oxygen and nutrients. Brain cells begin to die within minutes,” said Dr. Zacharias, who started off the lecture.

He then went on to explain the two broad categories of stroke: ischemic and hemorrhagic.

“An ischemic stroke is the most common type, responsible for more than 80 percent of strokes. It occurs when a blockage of an artery cuts off blood flow to a part of the brain,” Dr. Zacharias said.

Ischemic strokes can be caused by:

  • Embolism - a blood clot that travels from the heart or blood vessel up to the brain
  • Thrombosis - a blood clot that develops in the blood vessels inside the brain

Dr. Zacharias said that these clots may be caused by fatty deposits (plaque) that build up in arteries and cause reduced blood flow.

“The other type of stroke, hemorrhagic, occurs when a blood vessel in your brain leaks or ruptures. Blood spills into or around the brain and creates swelling and pressure,” stated Dr. Zacharias.

Warning Signs of a Stroke
Dr. Zacharias said, “There are a number of symptoms for stroke. Any sudden changes can be a stroke.”

The most common sign is sudden weakness of the face, arm or leg, most often on one side of the body. Other warning signs include sudden:

  • changes in speech or understanding speech
  • changes in vision
  • unsteadiness or loss of coordination
  • confusion
  • severe headache

If you think you or someone is having a stroke, immediately call 9-1-1. Also, check the time so you’ll know when the first symptoms appeared.

“People sometimes experience a transient ischemic attack, or TIA, which symptoms resemble those found in a stroke but usually last a few minutes. Even if all symptoms quickly resolve, it's still very important that you call 9-1-1 and immediately be evaluated by a qualified physician. A TIA is a warning sign of a possible future stroke and is treated as a neurological emergency,” said Dr. Zacharias.

Time is of the Essence for Treatment
"Never wait to see if symptoms will go away!" Dr. Zacharias warned. “You need to act quickly to save yourself or a loved one from potential disability or death.”

According to Dr. Zacharias, if you suffer an ischemic stroke, doctors work to restore blood flow to your brain with:

  • An injection of blood-thinning medication called tissue plasminogen activator (tPA), the gold standard treatment for ischemic stroke.
  • Emergency endovascular procedures, which are procedures performed directly inside the blocked blood vessel. Doctors may insert a catheter through a groin artery and thread it to your brain to deliver tPA directly into the area where the stroke is occurring. Or, doctors may use a catheter to maneuver a device into the blocked blood vessel and pull out the clot.

Other treatments may include surgical procedures that open up a narrowed artery running along the side of your neck to your brain.

Identifying Your Risk Factors
Dr. Zacharias explained that there are some risk factors for stroke you can't control, but it’s important for you to know them.

He said that genetics contributes to about 50 percent of your stroke risk. “Stroke tends to run in some families. Members of a family might have a genetic tendency for stroke risk factors such as an inherited predisposition for diabetes or high blood pressure.”

However, there are risk factors you can control. Dr. Zacharias noted that some of the most important treatable and modifiable risk factors for stroke are:

  • Hypertension (the No. 1 risk factor)
  • Diabetes
  • Cigarette smoking
  • Elevated cholesterol
  • Physical inactivity

He recommended talking to your health care provider about how to lower your risk for stroke if you have one of the above risk factors.

Reducing Your Risk from Atrial Fibrillation
Atrial fibrillation (AFib) is a type of irregular heartbeat that affects about 2.3 million people in the U.S. It occurs when there’s a malfunction in the heart’s electrical signals, causing it to beat rapidly and erratically. According to the National Stroke Association, AFib raises a person's risk for stroke by 500 percent. However, properly treating AFib can greatly reduce this risk.

Following Dr. Zacharias’ presentation, interventional cardiologist Srini Iyengar, MD, BCH's structural heart program director, spoke about a new way for AFib patients to protect themselves from stroke: the Watchman procedure.

According to Dr. Iyengar, blood-thinning medications, such as warfarin (Coumadin®), are the most common treatment for preventing AFib-related stroke. These clot-preventing medications can greatly reduce stroke risk if taken properly and no side effects are seen.

Yet, more than half of all AFib patients are not prescribed these medications. For certain individuals, there are barriers to taking a blood thinner, including dangerous interactions with other medications, dietary restrictions, high prescription costs and concerns about bruising or excessive bleeding from an injury.

Dr. Iyengar stated because of these concerns, the Watchman procedure could be an alternative to taking blood-thinning medications for some AFib patients.

Watchman is a one-time procedure performed under general anesthesia in a catheterization laboratory setting. The procedure usually lasts about an hour and the patient is typically in the hospital for 24 hours following the procedure. Learn more about Watchman here.

BCH is a Primary Stroke Center
BCH has been awarded Advanced Certification as a Primary Stroke Center by The Joint Commission and the American Heart Association/American Stroke Association. The Joint Commission’s Primary Stroke Center certification recognizes centers that make exceptional efforts to foster better outcomes for stroke care. Achievement of certification signifies that the services provided at BCH have the critical elements to achieve long-term success in improving outcomes. To learn more about our primary stroke center, click here.

View PowerPoint slides from the lecture on “Reducing Your Stroke Risk.” If you'd like to schedule an appointment with our lecture presenters, you can reach Srini Iyengar, MD, at 303-622-3980, or Alan Zacharias, MD, at 303-857-5867.

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