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Cardiovascular Disease: Is It a Heart Attack or a Stroke?

By MARILYN SOLTIS
Cardiovascular disease is the number one cause of death in this country— and stroke rates third—as well as ranking as a leading cause of disability. Both are caused by similar health and lifestyle issues concerning diet, weight, heredity, cholesterol, hypertension and diabetes. The ensuing blockage of the blood supply cause both heart attack and stroke.
 
What’s the difference? The main difference between a heart attack and stroke is, simply put, a heart attack affects the heart muscles and a stroke affects the brain. Immediate death can result from a heart attack but a stroke usually causes muscle paralysis. Time is critical from the onset of symptoms, and getting to the hospital quickly may mean the difference between life and death or severity of impairment.
   
In the case of stroke victims, many people aren’t aware that there are clot-busting drugs known as thrombolytic medications. The most commonly used is tissue plasminogen activator (tPA) for treating acute ischemic stroke caused by a blood clot to the brain. According to the National Institutes of Health (NIH), giving thrombolytics within three hours of the first stroke symptoms can help limit stroke damage and disability. There are some other drugs that can be used but the thrombolytics are the most commonly used.
 
Certain criteria must be met before administering the drugs: a brain CT scan to make sure there is no bleeding; a physical exam that shows a significant stroke; and, your medical history.
However, most stroke victims will not get the treatment. A study reported last year in Stroke: Journal of the American Heart Association revealed that an estimated 3.4 percent to 5.2 percent, or 23,800 to 36,000 of the 700,000 people in this country who suffered an ischemic stroke in 2009 actually received the treatment. The reasons for this include a reluctance of doctors to administer the drug due to a fear of bleeding complications; not seeing the patient soon enough for the drug to be effective; and, a lack of doctors trained to administer tPA.
 
Thrombolytic medications are also approved for treatment of heart attacks where they can dissolve major clots quickly and help restart blood flow to the heart. The American Heart Association reports a better chance of surviving and recovering from a heart attack if the patient is administered thrombolytic drugs within 12 hours.
  
Many issues are weighed by the health care provider before determining if someone is a good candidate for these drugs in case of a heart attack such as age, gender and various medical conditions. They will not be given to anyone suffering from bleeding problems, pregnancy, taking blood thinning medications; trauma or uncontrolled high blood pressure, among others.

Prevention Is Better than Treatment

The Mayo Clinic cites the most important factors in preventing heart disease and stroke: Don’t smoke; exercise most days for at least 30 minutes; eat a heart healthy diet; maintain a healthy weight; and get regular screenings for blood pressure, cholesterol levels and diabetes.

TIA or transient ischemic attack is a “warning stroke” or “mini-stroke.” The usual TIA symptoms are the same as that of a stroke, but they are only temporary and lack permanent brain injury.
 
If you think you are having a stroke, note the time symptoms began.

Warning Signs: When to Call 911

According to The American Heart Association and The American Stroke Association the following symptoms require immediate action:

Heart Attack

• Chest discomfort in the center of the chest lasting more than a few minutes that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Most heart attacks start slowly, with mild pain or discomfort.

• Pain or discomfort in one or both arms, the back, neck, jaw or stomach.

• Shortness of breath with or without chest discomfort.

• Breaking out in a cold sweat, nausea or lightheadedness.

Stroke

• Sudden numbness or weakness of the face, arm or leg, especially on 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.

Cardiac Arrest

• Sudden loss of responsiveness (no response to tapping on shoulders).

• No normal breathing (the victim does not take a normal breath when you tilt the head up and observe for at least five seconds).



Published: February 12, 2012
Issue: February 2012 Issue