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Stroke and Management of Cardiovascular Diseases

Welnex

An ischemic stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes.

A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications.

Symptoms
If you or someone you’re with may be having a stroke, pay particular attention to the time the symptoms began. Some treatment options are most effective when given soon after a stroke begins.

Signs and symptoms of stroke include:

Trouble speaking and understanding what others are saying. You may experience confusion, slur words or have difficulty understanding speech.
Paralysis or numbness of the face, arm or leg. You may develop sudden numbness, weakness or paralysis in the face, arm or leg. This often affects just one side of the body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Also, one side of your mouth may droop when you try to smile.
Problems seeing in one or both eyes. You may suddenly have blurred or blackened vision in one or both eyes, or you may see double.
Headache. A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate that you’re having a stroke.
Trouble walking. You may stumble or lose your balance. You may also have sudden dizziness or a loss of coordination.

Risk factors
Many factors can increase the risk of stroke. Potentially treatable stroke risk factors include:

Lifestyle risk factors

Being overweight or obese
Physical inactivity
Heavy or binge drinking
Use of illegal drugs such as cocaine and methamphetamine
Medical risk factors

High blood pressure
Cigarette smoking or secondhand smoke exposure
High cholesterol
Diabetes
Obstructive sleep apnea
Cardiovascular disease, including heart failure, heart defects, heart infection or irregular heart rhythm, such as atrial fibrillation
Personal or family history of stroke, heart attack or transient ischemic attack
COVID-19 infection

Other factors associated with a higher risk of stroke include:

Age — People age 55 or older have a higher risk of stroke than do younger people.
Race or ethnicity — African Americans and Hispanics have a higher risk of stroke than do people of other races or ethnicities.
Sex — Men have a higher risk of stroke than do women. Women are usually older when they have strokes, and they’re more likely to die of strokes than are men.
Hormones — Use of birth control pills or hormone therapies that include estrogen increases risk.

Complications
A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part is affected. Complications may include:

Paralysis or loss of muscle movement. You may become paralyzed on one side of the body, or lose control of certain muscles, such as those on one side of the face or one arm.
Difficulty talking or swallowing. A stroke might affect control of the muscles in the mouth and throat, making it difficult for you to talk clearly, swallow or eat. You also may have difficulty with language, including speaking or understanding speech, reading, or writing.
Memory loss or thinking difficulties. Many people who have had strokes experience some memory loss. Others may have difficulty thinking, reasoning, making judgments and understanding concepts.
Emotional problems. People who have had strokes may have more difficulty controlling their emotions, or they may develop depression.
Pain. Pain, numbness or other unusual sensations may occur in the parts of the body affected by stroke. For example, if a stroke causes you to lose feeling in the left arm, you may develop an uncomfortable tingling sensation in that arm.
Changes in behavior and self-care ability. People who have had strokes may become more withdrawn. They may need help with grooming and daily chores.

Preventive medications

If you’ve had an ischemic stroke or a TIA, your doctor may recommend medications to help reduce your risk of having another stroke. These include:

Anti-platelet drugs. Platelets are cells in the blood that form clots. Anti-platelet drugs make these cells less sticky and less likely to clot. The most commonly used anti-platelet medication is aspirin. Your doctor can help you determine the right dose of aspirin for you.

After a TIA or minor stroke, your doctor may give you aspirin and an anti-platelet drug such as clopidogrel (Plavix) for a period of time to reduce the risk of another stroke. If you can’t take aspirin, your doctor may prescribe clopidogrel alone.

Anticoagulants. These drugs reduce blood clotting. Heparin is fast acting and may be used short-term in the hospital.

Slower-acting warfarin (Jantoven) may be used over a longer term. Warfarin is a powerful blood-thinning drug, so you’ll need to take it exactly as directed and watch for side effects. You’ll also need to have regular blood tests to monitor warfarin’s effects.

Several newer blood-thinning medications (anticoagulants) are available for preventing strokes in people who have a high risk. These medications include dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa). They’re shorter acting than warfarin and usually don’t require regular blood tests or monitoring by your doctor. These drugs are also associated with a lower risk of bleeding complications compared to warfarin.

Compiled by Pharm(Mrs) Peace .O. Okorafor

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