When the brain's blood flow is severely curtailed or stopped completely, a stroke happens. The oxygen required by your brain tissue is not received. Death or severe disability may result from very small brain death regions. Stroke is the primary cause of disability in the US. Furthermore, it ranks as the third most common cause of death.

Two kinds of stroke exist. Hemorrhagic stroke: These strokes are not common. The medical term for bleeding is "hemorrhage.". A brain blood vessel leak or rupture is known as a hemorrhagic stroke. About 80% of stroke cases are of the ischemic type, which is far more common. The medical word "schemia" refers to decreased blood flow, which implies that less oxygen reaches your tissues. A blocked blood vessel stops oxygen from getting to specific areas of the brain, which leads to ischemic stroke.

Other terms for stroke include CVA, cerebral vascular accident, and cerebral thrombosis.

What is the cause of Stroke?

The most common kind of stroke, known as an ischemic stroke, is brought on by atherosclerosis, or the slow blockage of arteries. Buildup of plaque in your arteries leads to atherosclerosis. Lipids in your blood, such as cholesterol, are the building blocks of plaque. Over several years, the plaque progressively accumulates. However, plaque can eventually harden and cause the arteries to narrow. This may cause blood flow to slow down or stop completely, depriving your tissues of oxygen. A stroke may result from plaque buildup in the carotid artery in your neck.

But ignoring the wider picture is what happens when one says that plaque accumulation leads to stroke. Blood vessel blockage is influenced by a variety of health factors. Each of the following variables raises your risk of stroke and contributes in some way to plaque accumulation. Your chance of having a stroke increases with the number of risk factors you have.

Risk factors you can change

• Eating high-fat foods
• Drinking too much alcohol
• Lack of exercise
• Smoking
• Stress
• Excess weight

Risk factors you cannot change

• Age-the risk increases with age
• Gender-although men and women are equally likely to have a stroke, women are more likely to die from stroke
• Heredity-the risk increases if there is family history of stroke or blood vessel disease

Other health conditions that can increase your risk

• Atrial fibrillation
• Coronary artery disease (CAD)
• Diabetes
• High blood pressure
• High cholesterol
• Sleep apnea

To learn more, go to the Risk Factors section and the Health Conditions section (to learn about the individual conditions listed above).

What are the symptoms of Stroke?

Speech, comprehension, eyesight, and bodily movements are the first stroke symptoms to be noted because the brain regulates all of these bodily processes. The following are typical stroke symptoms, all of which appear suddenly:

• Numbness or weakness in the face, arm, or leg (especially on one side of the body)
• Confusion or trouble speaking or understanding Vision problems
• Dizziness or difficulty with walking, balance, or coordination Severe headache

Sometimes the immediate aftereffects of a stroke disappear on their own. This could indicate that you are experiencing a transient ischemic attack (TIA), a type of mini-stroke. TIAs only entail transient symptoms and typically don't harm the brain permanently. However, TIAs greatly increase your chance of suffering a full-blown stroke. They may also serve as a stroke warning indication.

Therefore, do not disregard signs if you see them. Get medical help right away. A stroke that could be deadly or incapacitating could be avoided with prompt treatment.

What tests could I have?

Your doctor could advise one or more of the tests on the following list to determine whether you are at risk of having a stroke. The outcomes of the test may also aid your doctor in determining the best course of action for you.

You may occasionally be referred to specialists for diagnosis, testing, and occasionally treatment. Visit the section on Your Treatment Team to find out more.

• Angiogram
• CT Scan Doppler Ultrasound
• MRI
• Stethoscope Test

Angiogram

What is an angiogram?

An angiogram is an image of your blood vessels, similar to an x-ray. An angiogram shows:

• How well the blood flows through the arteries
• Whether blockages exist-and if so, their location

An angiogram might be ordered if your doctor suspects blockages in:

• Your heart's arteries (called coronary arteries)
• Arteries outside your heart (called peripheral arteries)
• Arteries in your neck (called carotid arteries)

The cardiac catheterization precedes the angiography. A catheter, a short, flexible tube, is placed into a blood vessel in your arm or groin during a cardiac catheterization. Your doctor "steers" the catheter gently in the direction of your blocked blood vessel. Your doctor inserts the catheter and injects a dye to start the angiography. The dye makes it possible for images of your blood arteries to appear on a monitor, sort of like highways on a map. Your doctor might be able to perform a technique like balloon angioplasty right away to address the blocked artery right away if the angiography reveals one.

Computed Tomography (CT or CAT) Scan

What is a CAT scan?

An advanced form of x-ray is known as a computerized (or computed) tomography (CAT, or CT) scan. Let's use the example of the heart even though a CAT scan can be utilized to obtain images of many different body parts. A conventional x-ray produces images of the heart's length and breadth in two dimensions. However, a CAT scan makes use of an x-ray machine that goes around your body while taking several pictures of the heart. differing kinds of tissue absorb differing amounts of the x-rays as little amounts of them move through your body. When compared to a conventional x-ray, this helps to produce a more accurate image.

On a television monitor, the CAT scan images are combined to provide a three-dimensional perspective with length, width, and depth. A CAT scan provides a considerably more accurate image of the complete heart than a conventional two-dimensional x-ray since it is a three-dimensional image.

Numerous medical diseases can be found using a CAT scan, including cancers and bone issues like osteoporosis. A CAT scan is frequently used to determine the following in relation to heart and blood vessel disease:

• Some types of heart disease, such as heart failure
• A blood vessel blockage or blood clot

What can I expect?

Normally, before a computed tomography (CAT) scan, you take off your clothes and put on a hospital sheet or gown. On an exam table, you are lying. The table gently travels inside a doughnut-shaped machine as the test gets underway.

You may occasionally be given a contrast dye, typically through the insertion of an intravenous (IV) line into your arm. The dye enables images of your heart or blood vessels to appear on a monitor. The dye, for instance, makes your blood arteries visible during a test to examine them—almost like roads on a map. The dye may have the following effects on you:

• Warm flushing feeling, and maybe nausea, for a minute or so
• Metallic taste when the dye reaches the blood vessels in your mouth

The technician instructs you to maintain bodily stillness throughout the scan. You can sometimes maintain your position with the use of straps and/or pillows. The table gently glides through the apparatus as the x-ray tube revolves around your body. During the scan, you might be requested to hold your breath sometimes. Although the CAT scan is often not painful, lying still for anywhere between 15 and 60 minutes throughout the exam may make you feel uncomfortable.

Doppler Ultrasound

What is a Doppler ultrasound?

A three-dimensional, moving image of various body components is displayed during a Doppler ultrasonography. The ultrasound test used on pregnant women and this sort of test are extremely similar.

People cannot hear the sound waves that are emitted by the ultrasound equipment. The device records and monitors how the waves are reflected back as the sound echoes off of the body's fluids and tissues. Each sound wave's pitch and direction are measured by the device, even the smallest variations. The waves exhibit the following as they "echo" off of the blood vessels:

• How well blood flows through the blood vessels
• Whether there are blockages in the vessels
• If there are blockages, the location and extent of the blockage

Doppler ultrasound shows real-time images. For instance, it shows the actual movement of blood through arteries. So doctors use the test to find blockages in various parts of the body:

• In the coronary arteries in the heart (where a blockage can cause a heart attack)
• In the carotid arteries in the neck (where a blockage can cause a stroke)
• In blood vessels in the legs (where a blockage can lead to pain caused by peripheral vascular disease)

Doppler ultrasound technology is also used in an echocardiogram, which is a moving image of the heart.

What can I expect?

You might have to take off some or all of your clothing and change into a hospital gown before having a Doppler ultrasound. Then you lie on an examination table. On the area of your skin that will be tested (like the neck or leg), the technician applies gel. The gel aids in sound wave transmission. The technician will then glide a transducer, which resembles a pen, across your skin.

The sound waves bounce off your body and are picked up by the machine as echoes. The resulting image, a moving representation of your blood vessels, is subsequently displayed on the machine's computer screen.

A painless process, ultrasound. However, if you're obliged to undergo anesthesia, you may feel some discomfort as the sonographer moves the transducer over your body.

Magnetic Resonance Imaging (MRI)

What is magnetic resonance imaging (MRI)?

Using magnets, radio waves, and computer technology, magnetic resonance imaging (MRI) can provide images of various bodily parts. MRI is particularly helpful for capturing precise pictures of soft tissues. For instance, a lot of people get an MRI to examine their blood arteries and/or hearts.

In a sizable, tube-shaped machine, MRI is performed. A powerful magnetic field is produced by coils inside the machine's walls. Radio waves are sent and received by additional coils inside the machine's walls. Your body responds to the radio waves by sending out a few weak signals. A computer builds three-dimensional representations of the interior of your body as the device detects the weak signals.

The images can reveal:

• Blockages in blood vessels
• The size and thickness of your heart's chambers
• Damaged muscle from a heart attack
• How your heart valves are working

What can I expect?

You undress and put on a hospital gown or sheet prior to your magnetic resonance imaging (MRI). It is crucial to take off any jewelry, hearing aids, or other items containing metal before entering the MRI room. The MRI machine's powerful magnets could injure you if you have any metal on your body. An MRI is generally not recommended for most people who have a cardiac device, such as a pacemaker, implanted defibrillator, or heart failure device. Before making an appointment for an MRI, all patients with cardiac devices should consult their physician.

An intravenous (IV) line is inserted into your arm while you lie on a movable table in the MRI room. Throughout the procedure, the IV provides medication and fluids. The technician might, for example, inject contrast dye into the IV.

Your chest is covered in patches known as electrodes. An electrocardiogram's wires are connected to the electrodes (ECG). Throughout the procedure, your heart's activity is monitored by the electrodes and ECG. Your arm-worn blood pressure cuff is frequently used to take your blood pressure on a regular basis. The MRI scanner has no moving parts, but the table you are lying on slides into it. The machine makes thumping noises, which you can block out with headphones or earplugs. During some portions of the test, the technician may ask you to hold your breath or lie very still. On the other hand, you might notice twitching in your toes or fingers.

Stethoscope Test

Your doctor can listen to your blood flow using a stethoscope to detect a carotid artery blockage that could result in a stroke. A blockage may be indicated by an unusual whooshing sound, known as a bruit, as the blood flows through the artery. A stethoscope examination is a useful initial test. Additionally, your doctor might request follow-up exams.

What are the treatment options?

Prompt medical attention can make the difference between life and death in cases of stroke. It can also lessen your risk of being disabled. Medication is typically part of prompt treatment and is given to you in the hospital right away.

Later, based on the outcomes of your tests, your doctor might also suggest one or more of these treatments.

Medications

Anticoagulants (antiplatelets)

Procedures

• Balloon Angioplasty
• Endarterectomy
• Stent Implant

Tips for Taking Heart Medications

You might wish to learn more about some of the medications you take if you have a heart or blood vessel condition. Some drugs that are frequently recommended for heart or blood vessel disorders are described in this section. Additionally, it offers some advice on how to take your drugs as directed.

Make sure to disclose all prescription medications and dietary supplements you are using to your doctor and any new doctors who will write you a prescription. Then, your doctor can assist in ensuring that you receive the most from your prescriptions. Informing your doctor of this information also helps to prevent negative drug interactions.

Every time you receive a new drug, you might also wish to bring up the following issues with your doctor or nurse:

• The reason you're taking the medication, its expected benefits, and its possible side effects
• How and when to take your medications
• If you take other medicines, vitamins, supplements, or other over-the-counter products

Your heart may occasionally require several months to acclimatize to new drugs. So it's possible that you won't see any progress immediately away. Your doctor's evaluation of the proper dosage can take some time as well.

Blood testing may occasionally be required for patients on heart medicines. The blood tests assist your doctor in determining the proper dosage, assisting in the prevention of negative side effects.

Never alter your medication's dosage or stop taking it on your own initiative because you feel better without it, no longer need it, or don't think it's functioning as intended.

If you have: Be sure to discuss it with your doctor or nurse.

• Questions about how your medications work
• Unpleasant side effects
• Trouble remembering to take your pills
• Trouble paying for your medications
• Other factors that prevent you from taking your medications as needed
• Questions about taking any of your medications

And don't hesitate to ask your pharmacist if you have questions about how and when to take your medications.

Anticoagulants (Blood Thinners)

By examining the term's underlying terms, you can learn what anticoagulants are used for. Coagulant means to thicken or clot, and anti means against.

Some Generic (and Brand) Names

The Food and Drug Administration (FDA) has given its approval to all drugs for a certain patient population or ailment. The right medication for you is something only your doctor can tell you.

• aspirin
• clopidogrel (Plavix)
• ticlopidine (Ticlid)
• warfarin (Coumadin)

What They're Used For

To reduce the risk of blood clots that could lead to stroke and other medical conditions

#

How They Work

Although they don't actually thin the blood, anticoagulants are sometimes referred to as blood thinners. Instead, they aid in preventing blood clots from developing.

These drugs address ailments brought on by atherosclerosis, or plaque-clogged arteries. A blood clot can result from plaque accumulation.

• A blood clot in the coronary arteries (which carry blood to the heart muscle) can cause angina (chest pain). A clot or blockage in the coronary arteries is called coronary artery disease (CAD) and could lead to a heart attack.
• A blood clot in the carotid arteries (in the neck) can travel to the brain and cause a stroke.
• A blood clot in the vessels in the arms or legs, called peripheral vascular disease (PVD), can cause pain.

Taking anticoagulant medications can:

• Decrease the stickiness of the blood
• Reduce the likelihood of blood clots forming

Balloon Angioplasty

What is a balloon angioplasty?

A balloon angioplasty opens blocked blood vessels by pressing plaque against the artery wall. It is a procedure that uses local numbing. General anesthesia usually is not needed.

This procedure opens the artery and allows blood to flow more freely, which can reduce your:

• Risk of heart attack-in the coronary arteries
• Level of pain in your legs or arms-in the peripheral arteries
• Risk of stroke- in the carotid arteries

How is the procedure done?

You undress and put on a hospital gown or sheet prior to your magnetic resonance imaging (MRI). It is crucial to take off any jewelry, hearing aids, or other items containing metal before entering the MRI room. The MRI machine's powerful magnets could injure you if you have any metal on your body. An MRI is generally not recommended for most people who have a cardiac device, such as a pacemaker, implanted defibrillator, or heart failure device. Before making an appointment for an MRI, all patients with cardiac devices should consult their physician.

An intravenous (IV) line is inserted into your arm while you lie on a movable table in the MRI room. Throughout the procedure, the IV provides medication and fluids. The technician might, for example, inject contrast dye into the IV.

Your chest is covered in patches known as electrodes. An electrocardiogram's wires are connected to the electrodes (ECG). Throughout the procedure, your heart's activity is monitored by the electrodes and ECG. Your arm-worn blood pressure cuff is frequently used to take your blood pressure on a regular basis. The MRI scanner has no moving parts, but the table you are lying on slides into it. The machine makes thumping noises, which you can block out with headphones or earplugs. During some portions of the test, the technician may ask you to hold your breath or lie very still. On the other hand, you might notice twitching in your toes or fingers.

What can I expect?

Usually, you are instructed to refrain from eating or drinking for a period of time prior to the treatment. You will get your procedure in a "cath lab." An intravenous (IV) line is inserted into your arm when you are lying on an examination table. During the surgery, the IV administers fluids and drugs. You get drowsy but not unconscious from the drug.

For the catheter, the doctor creates a tiny incision. You won't feel any pain because the region will be numbed, but you might feel some pressure as the catheter is inserted. Your doctor or nurse may question you during the angioplasty to make sure you are not in discomfort, for example. You might spend the night in the hospital. But the majority of people have a fairly rapid

Endarterectomy

What is an endarterectomy?

• An endarterectomy is a kind of blood vessel surgery. This surgery opens blocked blood vessels by removing plaque buildup from inside the artery wall. This allows blood to flow more freely through your arteries. An endarterectomy is usually done to clear plaque from two types of vessels:
• The carotid arteries in the neck-to reduce your risk of stroke
• The peripheral arteries in the legs and arms-to relieve pain

An endarterectomy is a surgery that usually requires general anesthesia.

How is the surgery done?

The obstructed blood vessel is the site of the endarterectomy. But the procedure is performed in the same manner wherever it is performed.

For instance, your doctor may need to make a neck incision to access a blocked carotid artery. Your doctor locates the obstruction and then inserts a tube, known as a shunt, above and below the obstruction. During surgery, the shunt reroutes the flow to avoid the obstruction. The plaque is removed by your doctor using a specialized tool. Your doctor will suture your carotid artery and the wound after the shunt has been removed.

What can I expect?

Usually, a few hours prior to your procedure, you are instructed to refrain from eating or drinking anything. An intravenous (IV) line is inserted into your arm when you are lying on an examination table. During surgery, the IV administers fluids and drugs. The operating chamber is then brought over to you. You are typically given a drug to render you asleep throughout the procedure. You might stay in the hospital for 1-2 days following surgery. It's crucial not to move your neck too quickly or frequently for a few weeks after you leave the hospital.

Stent Implant

What is a stent?

A thin mesh tube called a stent keeps an artery open. In order to lower the possibility of a subsequent blockage or narrowing after an angioplasty operation, your doctor places a stent in a freshly opened artery. Stents are frequently implanted in the carotid and coronary arteries that carry blood to your neck and heart, respectively. Local anesthesia is employed during a stent implant surgery. Typically, general anesthesia is not required.

The two types of coronary artery stents are drug-coated and bare metal. A drug-coated stent is a bare metal stent that has been treated with a particular medicine to assist lower the risk of the artery getting blocked once more. that drug

Over time, the stent's coating is shed when a new blockage is most likely to occur.

A drug-coated stent implant could lessen the need for a subsequent procedure to reopen the artery (such a coronary stent procedure or bypass surgery).

How is the implant procedure done?

Your doctor may perform an atherectomy or balloon angioplasty to open the blocked artery prior to implanting a stent. Catheterization is required for those procedures as well as the stent implant. In a catheterization, a tiny, flexible tube known as a catheter is inserted into your groin (or occasionally your arm) through a blood vessel. When guiding the catheter toward your obstructed vessel, your doctor does so gently.

Your blood vessels can be seen as pictures on a monitor, much like roads on a map, thanks to dye injected through the catheter. An angiography is the term for this portion of the procedure. Usually, a stent implant includes the catheterization and angiography.

Once the blockage has been removed, the doctor inserts the stent into your newly opened artery using a specialized catheter. The stent provides assistance:.

• To allow blood to flow freely, keep the artery open.
• Avoid the artery becoming blocked by plaque accumulation once more.

What can I expect?

Your doctor may perform an atherectomy or balloon angioplasty to open the blocked artery prior to implanting a stent. Catheterization is required for those procedures as well as the stent implant. In a catheterization, a tiny, flexible tube known as a catheter is inserted into your groin (or occasionally your arm) through a blood vessel. When guiding the catheter toward your obstructed vessel, your doctor does so gently.

Your blood vessels can be seen as pictures on a monitor, much like roads on a map, thanks to dye injected through the catheter. An angiography is the term for this portion of the procedure. Usually, a stent implant includes the catheterization and angiography.

Once the blockage has been removed, the doctor inserts the stent into your newly opened artery using a specialized catheter. The stent provides assistance:.

• To allow blood to flow freely, keep the artery open.
• Avoid the artery becoming blocked by plaque accumulation once more.