Stroke and Screening Information

Background
Cardiovascular disease, which includes both heart attack and stroke, is the leading cause of death among all racial and ethnic groups, and for both sexes in the United States and Missouri. When examined along, heart disease is the leading cause of death, with stroke the third leading cause of death. The effects of cardiovascular disease also have an economic impact. Cardiovascular diseases cost Missourians roughly $3.5 billion dollars in direct hospital charges each year (dhss, 2006). Cardiovascular disease is one of the most preventable diseases. Major risk factors for strokes are lifestyle related and can be controlled. These risk factors include tobacco use, physical activity, diet and maintaining a health weight. You are also at a greater risk of stroke if you have diabetes, hypertension (high blood pressure), or have suffered a stroke in the past (KCCHA, 2006).

What is a Stroke?
Strokes are characterized into two different types, ischemic or hemorrhagic. Ischemic strokes occur as the result of a lack of oxygen, usually caused by a blood clot. As a result, the area of the brain affected is unable to function. The second type of stroke, which is less common than ischemic stroke, occurs due to a rupture vessel in the brain. The signs and symptoms of stroke typically start suddenly, over second to minutes, and in most cases do not progress further. In both types, there may be an inability to move limbs on one side of the body, inability to understand or create speech, or the inability to see one side of the visual field. Blood carries oxygen and nutrients to the brain. When blood flow to part of the brain stops, that part of the brain starts to die within minutes. The dying cells then release chemicals that can damage other cells. The symptoms depend on the area of the brain affected. If the brain is extensively affected, more functions are likely to be lost.

Transient Ischemic Attacks (TIAs) are related to strokes, sometimes called “ministrokes”. These ministrokes are caused by short interruptions of blood flow to the brain. The effect is only temporary, lasting as long as 24 hours. TIAs can be an important warning sign. As may as 1 out of 3 individuals who suffer a TIA will have a stroke in the future (2008).

How to Recognize a Stroke
According to the American Stroke Association, one of the easiest and most effective ways to increase recognition of stroke is the F.A.S.T. system. F.A.S.T. stands for Face, Arm, Speech, and Time (NSA, 2009). The most frequently occurring warning signs include:

• sudden numbness or weakness of the face, arms, or legs, especially on only one side of the body
• sudden confusion, trouble speaking or understanding
• sudden trouble seeing in one or both eyes
• sudden trouble walking, dizziness, loss of balance or coordination
• sudden severe headache with no known cause

Taking Action
It should be noted that not all warning signs occur in every stroke. Also, do not ignore signs if the happen to go away. Immediately call 9-11 or your local Emergency Medical Service (EMS) number so that an ambulance can quickly be sent to you.

How Can You Prevent a Stroke?
• Don’t smoke
• Keep your blood pressure under control
• If you have diabetes, treat and monitor it
• Eat a healthy diet consisting mostly of fruits, vegetables, and whole grains
• Maintain a healthy weight
• Stay active
• Keep your blood cholesterol under control

Stroke Screenings
Because up to 80 percent of strokes are preventable, being screened is important. Patients who have already suffered a stroke are at an increased risk and should have ultrasounds done on the carotid arteries, the abdominal aorta, and the peripheral arteries in the lower legs. These ultrasounds can detect harmful blood clots that may eventually lead to stroke or heart attack.

Sources
Stroke fact sheet. (2008). Retrieved from http://www.diseaseriskindex.harvard.edu/
update/hccpquiz.pl?lang=english&func=show&quiz=stroke&page=fact_sheet

Missouri plan for heart disease and stroke prevention. (2006, December). Department of Health and Senior Services

Heart disease and stroke. (2006). Kansas City Community Health Assessment

Learn to recognize a stroke. (2009, December 15). Retrieved from http://www.strokeassociation.org/presenter.jhtml?identifier=1020

Life line medical screening services. (n.d.). Retrieved from http://www.lifelinescreening.com/health-screening-services/default.aspx