According to the Australian Bureau of Statistics, stroke is our third leading cause of death. Basically, part of the brain dies, and functions controlled by that part are lost or weakened – movement, sensation, speech and/or vision. This results from either infarction (where a clot or plaque blocks a feeding artery), or less commonly from a bleed.
Conditions that increase the risk of heart disease also increase the risk of stroke: high blood pressure, high cholesterol, diabetes, kidney problems, obesity, smoking and family history.
Atrial fibrillation (AF) is a risk factor for stroke. With age, heart conditions, or even alcohol excess, the left atrium of the heart becomes dilated and beats irregularly and out of sync with the main heart chambers, the ventricles. The fibrillating atrium can develop a clot which can travel to the brain.
Atrial fibrillation may cause palpitations or dizziness, but many cases are picked up by the doctor checking the pulse, or by an ECG. Some people just get occasional episodes of AF, which can be difficult to diagnose. Medication to slow the heart beat may be prescribed if AF is fast.
Many people need to commence blood thinners, such as warfarin, or newer anti-coagulants. As the world is imperfect, so is medicine – blood thinners reduce the chance of a clot and stroke, but also increase the chance of bleeding (for example a bleed in the brain, stomach or from the nose).
There are formulas used to determine stroke risk in AF, to assist the decision to prescribe. Blood thinning is usually then life-long, with close monitoring along with attention to other risk factors.
