AHA: Stroke Symptoms, Even Those That Go Away Within 1 Hour, Need Emergency Care

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People who have transient ischemic attacks (TIAs), which are symptoms of stroke that go away in less than 1 hour, need emergency evaluation to help prevent full-blown strokes, according to a scientific statement published by the American Heart Association (AHA). ) in Race.

The statement includes a standardized approach for evaluating people with suspected TIA, including guidance for hospitals in rural areas that may not have access to advanced imaging or an on-site neurologist.

“Confidently diagnosing a TIA is difficult, as most patients have returned to normal functioning by the time they arrive in the emergency room,” Hardik Amin, MD, chair of the scientific statement writing committee and associate professor of neurology and medical director of stroke at Yale. New Haven Hospital, in a statement.

“There is also variability across the country in the study that TIA patients can receive. This may be due to geographic factors, limited resources at healthcare facilities, or different levels of comfort and expertise among medical professionals,” Amin said.

The new statement also includes guidance intended to help healthcare professionals identify and understand the difference between a TIA and a “mock TIA,” which is a condition that shares some signs with TIA but is the result of others. medical conditions, including low blood sugar, migraines, or seizures. TIA symptoms typically mimic spread to other parts of the body and intensify over time.

The symptoms of TIA are the same as those of a stroke, including facial drooping, numbness, and weakness on one side of the body, but they last less than an hour.

People with cardiovascular risk factors, such as diabetes, high blood pressure, high cholesterol, obesity, and smoking, are at increased risk of stroke and TIA.

Other conditions can also increase risk, such as atrial fibrillation, coronary artery disease, obstructive sleep apnea, peripheral arterial disease, and previous stroke.

After evaluating symptoms and medical history, imaging of the blood vessels in the head and neck should be evaluated, according to the AHA.

A CT scan can be used to rule out intracerebral hemorrhage and TIA mimics, while an MRI can rule out our brain injury.

The AHA also suggests blood tests to rule out any other conditions that may cause TIA-like symptoms and to check for cardiovascular risk factors, such as diabetes and high cholesterol.

Cardiac workup can also be used once TIA is diagnosed to help with the heart-related factors that cause TIA.

“Incorporate these steps to [individuals] with suspected TIA can help identify which patients would benefit from hospital admission versus those who could be safely discharged from the ER with close follow-up,” Amin said. “This guide empowers clinicians in both rural and urban academic settings with information to help reduce the risk of future strokes.”

In addition, clinicians should use the 7-point ABCD2 score to assess an individual’s risk of future stroke after a TIA based on age, blood pressure, clinical features, diabetes, and duration of strokes. symptom.

Patients with a moderate (4 to 5 points) or high (6 to 7 points) score should be considered for hospitalization, according to the AHA.

Collaboration among healthcare professionals is essential to ensure that patients receive comprehensive assessments and well-communicated outpatient plans to help prevent future strokes, according to the statement authors.

Reference

Stroke symptoms, even if they clear up within an hour, need emergency evaluation. Eurek alert. Press release. January 19, 2023. Accessed January 20, 2023. https://www.eurekalert.org/news-releases/976672

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