Evaluation needed to gauge silent threat lurking within stroke patients

DALLAS, Sept. 9 Up to 40 percent of patients with "mini strokes" and ischemic strokes have silent heart disease, so doctors need to evaluate their heart risk even if patients don't have symptoms, according to an American Heart Association/American Stroke Association scientific statement published in today's Circulation: Journal of the American Heart Association.

Stroke survivors found to be at high risk may also need non-invasive testing, according to the statement's lead author Robert Adams, M.D., Presidential Distinguished Chair, Regents Professor of Neurology, at the Medical College of Georgia in Augusta.

Coronary heart disease, transient ischemic stroke (TIA known as "mini stroke,") and ischemic stroke all result from vascular disease, where blood flow is restricted to either the heart or brain. The panel of researchers found a link between silent heart disease and TIA and with silent heart disease and ischemic strokes originating in large vessels to the brain.

"Compared to patients with strokes caused by blockage in small vessels in the brain, patients with TIA or large-vessel strokes have a higher likelihood of also having coronary artery disease, whether or not they have a clear history of heart disease," Adams said. While there are guidelines for coronary heart disease and managing stroke, there was no summary of how doctors should approach coronary risk in relatively healthy patients with stroke who have no recognized symptoms or history of heart disease, he said. "There are data to indicate that some people already have significant heart disease by the time they have a stroke even though they don't have any recognized symptoms of heart disease," said Adams, past chairman of the American Heart Association's Stroke Council Leadership Committee.

The authors reviewed literature on short- and long-term outcomes of stroke survivors. Overall, they discovered that the risk of heart attack or sudden cardiac death after stroke

Contact: Carole Bullock
American Heart Association

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