Posts Tagged ‘stroke’

Takeaways from the Peripheral Arterial Disease (PAD) Treatment Options Live Chat

pad-260x200Thank you to everyone who attended and participated in our Peripheral Arterial Disease (PAD) live chat on Tuesday, January 24th with the Emory Heart & Vascular Center’s Chief of Vascular Surgery, Dr. William Jordan. Peripheral Arterial Disease (PAD) affects 8 to 12 million people in the United States, especially those over 50. Those who suffer from PAD are at increased risk for heart disease, aortic aneurysms and stroke. PAD is also a marker for diabetes, hypertension and other conditions.

Dr. William Jordan was able to answer all of your questions about PAD and the various treatment options available. We received a lot of awesome questions which you can find in the full chat transcript here. Below are some highlights from our live chat.

 

Question: How do I get tested for PAD?

Dr. Jordan: A thorough physical exam would be the first test. Non-invasive testing with blood pressure cuffs on the legs along with low-grade treadmill walking can usually confirm the diagnosis. It is best to see a vascular specialist to be tested.

Question: Are there clinical trials for PAD?

Dr. Jordan: Yes, Emory participates in the BEST-CLI study which is an NIH sponsored study to compare open vs. endovascular treatment for PAD. We also are constantly evaluating new treatment modalities as new devices become available.

Question: What do you think the best way to treat PAD is?

Dr. Jordan: The first line would be medical therapy, including lifestyle changes such as exercise, diet and nicotine cessation. If there is not improvement from medical therapy, we will consider the patient for reconstruction- bypass or stent.

 

Thank you again to everyone who joined us for our PAD live chat! You can learn more about the Emory Heart & Vascular Center here.

Peripheral Arterial Disease (PAD) Treatment Options Live Chat: January 24, 2017

pad-260x200Peripheral Arterial Disease (PAD) affects 8 to 12 million people in the United States, especially those over 50. Those who suffer from PAD are at increased risk for heart disease, aortic aneurysms and stroke. PAD is also a marker for diabetes, hypertension and other conditions.

Join us on Tuesday, January 24th at 12pm when the Emory Heart & Vascular Center’s Chief of Vascular Surgery, Dr. William Jordan,  will answer all of your questions about PAD and the various treatment options available. All are welcome to attend this open chat with our physicians.

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Warning Signs of a Stroke

strokeStrokes strike fast and, unfortunately, often. Stroke is the fourth leading cause of death in America today, and one of the leading causes of disability. People over 55 years old have more chance of stroke, and the risk gets greater as you get older.

How does stroke happen? A stroke happens when a blood vessel bringing blood and oxygen to the brain gets blocked (ischemic stroke) or ruptures (hemorrhagic stroke). When this happens, brain cells don’t get oxygen thy need. As a result, that part of the brain can’t work, and neither can the part of the body it controls. Damage may be temporary or permanent depending on how many cells are lost.

Warning Signs During a Stroke

Sometimes symptoms of stroke develop gradually. But if you are having a stroke, you are more likely to have one or more sudden warning signs:

  • Numbness or weakness in your face, arm, or leg, especially on one side of the body
  • Confusion, trouble speaking or understanding
  • Trouble seeing with one or both eyes
  • Trouble walking, dizziness, loss of balance or coordination
  • Trouble walking or staying balanced or coordinated
  • Dizziness
  • Severe headache with no known cause

TIAs

TIA, or transient ischemic attack, is a warning stroke that can happen before a major stroke. They happen when a blood clot clogs an artery for a short time. The signs of a TIA are like a stroke, but they usually last only a few minutes. About 15 percent of major strokes are preceded by TIAs, so if be sure to seek medical help right away if you have any of the warning signs.

Certain risk factors can increase the likelihood of a stroke, such as:

  • Uncontrolled high blood pressure
  • High blood cholesterol
  • Heart disease
  • Smoking
  • Obesity

What to Do if You Suspect a Stroke

Every second counts when it comes to caring for someone who has had a stroke. A stroke is a medical emergency, and if you or someone else has any warning signs, you should call 9-1-1 immediately. Be sure to take note of the time when the first signs occurred. If treated within three hours, medications can reduce the risk of long-term disability.

Vascular Surgery to Avoid Stroke

Vascular surgery is an option for managing diseases of the carotid artery, which is the neck vessel that provides blood to the brain. Blockage in this vessel can result in strokes if left untreated. Carotid artery disease can be managed by medication, placement of a stent, or with open surgery to clear the blockage through a small neck incision. The vascular surgeon decides on the appropriate management of patients with carotid artery blockage depending on the degree of narrowing and the patient’s symptoms and risk factors.

About Yazan Duwayri, MD

duwayri-yazanYazan Duwayri, MD is an Assistant Professor of Vascular Surgery and Endovascular Therapies at Emory University School of Medicine. He is an Emory Healthcare Network Physician at Emory University Hospital and Emory University Hospital Midtown. He serves as the vascular surgery quality officer at Emory University. He received his vascular surgery and endovascular training at Washington University School of Medicine in Saint Louis, Missouri. He specializes in the minimally invasive treatment of vascular disorders including carotid artery disease, aortic aneurysms, and peripheral arterial disease.

What is a Blood Clot?

bloodclot_7-17When you get a cut, blood clotting is your body’s healthy response to stem the bleeding and begin to close the wound so it can heal. But too much of a good thing can cause problems if it happens inside the body and obstructs blood flow through healthy blood vessels. Depending on where the clot (or “thrombus”) occurs and ends up–they can travel in your blood vessels– it can cause serious problems that require medical attention, including stroke, heart attack, or pulmonary embolism (clot in the lungs).

At risk

Unhealthy clotting can be caused or exacerbated by a number of factors, so it’s worth being aware of danger signs if you take certain medications (like oral contraceptives, hormone therapy drugs and some breast cancer medications), have a family history of blood clots or heart problems, smoke, , are pregnant, obese, have high cholesterol or have recently had surgery.

Causes for concern

Here are some red flags that could indicate a problem. You should seek medical assistance if you have swelling, redness, numbness or pain in an arm or leg, or you:

  • feel short of breath;
  • experience chest pain for more than a few minutes;
  • have pain that extends into your arm, back, shoulder or jaw;
  • have sudden severe lightheadedness
  • have numbness in your face, arm, or leg
  • have sudden trouble speaking or understanding others
  • have sudden trouble seeing (e.g., blurred or double vision)
  • have sudden weakness in an arm or a leg

Treatment

Your doctor will need to consider all medications, supplements, and herbs you’re taking, for their potential impact on blood clotting. Your history, a physical exam, blood tests and imaging may all be used to confirm diagnosis. Depending on the location and severity, drugs to dissolve the clot (or keep it from growing larger) or surgery to remove it might be indicated. There are two types of blood thinning drugs you might be prescribed, anticoagulants (such as warfarin) or antiplatelets (such as aspirin). If you have had a stroke or a heart attack, you will also need a cholesterol medication called statin to reduce the chance of a future event.

Prevention 

Keep that blood moving! Maintaining an active, non-smoking lifestyle with regular exercise, healthy weight and diet and low blood pressure could go a long way in preventing risk factors. Try to break up long periods of sitting with breaks to walk around. If you have risk factors, talk with your doctor about habits and/or drugs that can reduce your risk.

About Dr. Jaber
Wissam Jaber, MD is a cardiologist at Emory University Hospital Midtown where he runs the pulmonary embolism treatment program.  He has more than 7 years of experience in interventional cardiology, including treating patients with heart attack and blocked heart arteries.

What’s Causing Your Leg Pain? – Join Us for a Live Web Chat!

PAD Live ChatPeripheral artery disease (PAD) is a commonly undiagnosed disease affecting about 8.5 million Americans. Symptoms vary from cramping in the lower extremities, as well as pain or tiredness in leg or hip muscles. According to the American Heart Association, many people mistake the symptoms of PAD for something else, which is why it can easily go undiagnosed. Having the correct diagnosis is important because people with PAD are at a higher risk of heart attack or stroke, and if untreated, PAD can lead to gangrene and amputation.

Many people think their leg pain is due to arthritis, sciatica or just a part of aging. People with diabetes may even confuse PAD pain with a neuropathy, a common diabetic symptom that causes a burning or painful discomfort of the feet or thighs. It is important to know that, while PAD is potentially life-threatening, it can be managed or even reversed with proper care. If you’re having any kind of recurring pain, talk to your healthcare professional.

Join me on Tuesday, March 24, at 12:00 p.m. for an interactive web chat entitled “What’s causing your leg pain?” Dr. Robertson will be available to answer questions and discuss various topics about PAD, including symptoms, diagnosis and misdiagnosis, prevention and treatment.

During this interactive web chat, you’ll be able to ask questions and get real-time answers from our Emory Healthcare professional.

Register now for our March 24 chat at emoryhealthcare.org/mdchats.

About Dr. Robertson

Gregory Robertson, MDGreg Robertson, MD, is the chief of the Emory Heart and Vascular Clinic at Johns Creek. At the Emory Johns Creek Hospital he is chief of cardiology and the medical director of the Cardiac Catheterization laboratory and interventional program. He is board certified in Vascular Medicine, Endovascular Medicine, Interventional Cardiology and Cardiovascular Medicine.

Dr. Robertson’s research has had a focus on the development of new technologies and techniques to treat blocked leg arteries in patients with peripheral arterial disease, helping patients walk farther and prevent limb amputation in diabetic patients. While in the San Francisco Bay Area for 16 years before moving to Atlanta, he practiced with the well-known medical device inventor Dr. John Simpson, whose development teams invented the atherectomy procedure and the first percutaneous arterial closure device. Atherectomy is a procedure which allows the physician to remove plaque in blocked arteries without major surgery. His newest project is with Dr. Simpson’s invention of the Avinger Ocelot and Pantheris devices which open blocked arteries using smart laser imaging.

Dr. Robertson’s clinical expertise is oriented on performing minimally-invasive procedures to avoid major surgery. He has developed many of the vascular programs at the new Emory Johns Creek Hospital including 1) carotid artery stenting, 2) percutaneous repair of abdominal aortic aneurysms and 3) limb preservation for those at risk of limb amputation. He has also developed the cardiac intervention programs for emergency heart attack victims and elective procedures to include PCI and PFO/ASD closure.

How an Irregular Heartbeat Can Increase Your Risk of Stroke

Irregular HeartbeatAtrial fibrillation (AF) is the most common arrhythmia seen by physicians. AF is a condition in which the two of the heart’s four chambers beat irregularly. According to the American Heart Association, the risk of stroke is 5 times higher in patients diagnosed with AF because of an increased risk for clots in the heart chambers.

Depending on a patient’s age and other clinical risk factors for stroke, a scoring system is typically generated that will help classify that patient’s stroke risk. Patients with one or more risk factors for stroke are usually advised to take blood thinners for stroke prevention. Warfarin (or Coumadin) and other newer agents Pradaxa®, Xarelto® or Eliquis®  are proven therapies for stroke prevention in AF patients. All of these medications have proven to be safe and effective. Nevertheless, some patients may not tolerate these medications or could develop bleeding complications. In that case, a new option for stroke prevention has been studied and is awaiting FDA approval.

This new therapy is called the “Watchman” device. This device is delivered via a minimally invasive procedure (entry via the femoral vein) into the left atrium. In the left atrium this device is used to cover the left atrial appendage. X-Ray and echocardiography are used to guide this procedure. The left atrial appendage is a structure in the left atrium, or left heart chamber, that has a “cul-de-sac” shape and is responsible for the majority of clot formation in patients with non-valvular AF.

Emory Electrophysiologists have participated in the original studies of the “Watchman” device, which may lead to FDA approval. To schedule an appointment with an Emory Electrophysiologist, please call 404-778-7777 or visit emoryhealthcare.org/arrhythmia.

About Dr. El-Chami

Mikhael El Chami, MDMikhael El-Chami, MD, is an Assistant Professor of Medicine at Emory University and is the director of the arrhythmia clinic at Emory University Hospital Midtown.

Dr. El-Chami received his undergraduate and doctorate of medicine degree at the American University of Beirut in Lebanon. Following his internship and residency at Emory University School of Medicine in Atlanta, he was selected to be a chief medical resident at Emory University Hospital Midtown. After completion of his Chief Residency he also finished a cardiology and cardiac electrophysiology fellowship at Emory. He has been an Emory Faculty member since 2008. He is a Fellow of the American College of Cardiology and the Heart Rhythm Society, as well as an Alpha Omega Alpha honor medical society member.

Dr. El-Chami’s professional interests involve the treatment of heart rhythm disorders and prevention of sudden cardiac death. He has had numerous publications in the field of electrophysiology and continues to be involved in research on a number of studies related to atrial fibrillation and management of heart failure through device therapy.

Did you Know that Stroke is the Third Leading Cause of Death in Women? Learn how to Protect Yourself!

StrokeRisk factors for heart disease and stroke can be different for women versus men so it is exciting to note that earlier this year, the American Heart Association in conjunction with the American Stroke Association released new stroke prevention guidelines specifically for women!

The guidelines, based on scientific findings, offer tips on how to reduce risk factors for stroke as well as treatment protocol if a stroke does occur. The American Heart Association/American Stroke Association outlines the following:

  • Women who have had high blood pressure before pregnancy she be closely monitored by a physician to evaluate the need for adding medications to try to lower the risk for preeclampsia.
  • The following are risk factors that increase the risk for stroke:
    • Obesity
    • Smoking
    • High cholesterol

A patient should work with her physician to determine the best way to reduce these risk factors with lifestyle modifications such as diet and exercise.

  • Women who had preeclampsia, a condition some women develop during pregnancy that is typically characterized by high blood pressure, swelling and fluid retention, have a higher probability of stroke during or after pregnancy. Therefore, women who have had preeclampsia should develop a prevention plan in conjunction with their physician in order to mitigate the risk from this condition.
  • Women who are pregnant with moderate to severe high blood pressure should work with their physician to determine if they should be actively treated for the condition.
  • Birth control pills in combination with high blood pressure can increase the risk of stroke in female patients. Therefore, before a woman is prescribed birth control pills, she should be screened for high blood pressure.
  • If you suffer from migraine headaches, stop smoking! Scientific research shows that women with migraine headaches who smoke are at higher risk for a stroke.
  • Get screened for atrial fibrillation if you are a woman over 75 years old.

The Emory Women’s Heart Center offers screenings for women who could be at risk for heart disease. Take the short online quiz to see if you are at risk.

If you have one or more risk factors, we encourage you to schedule a comprehensive heart screening. During the screening you will develop an individualized risk reduction action plan to help prevent heart disease and stroke. Heart disease and stroke are preventable if you take action to develop a healthy lifestyle!

Heart Disease Screening

Also, to get more information on how to reduce your risk, we invite you to attend a Stroke Awareness Event at Emory Healthcare during May!

About the Emory Women’s Heart Center

Emory Women’s Heart Center is a unique program dedicated to screening, preventing and treating heart disease in women. The Center, led by nationally renowned cardiologist Gina Lundberg, MD provides comprehensive cardiac risk assessment and screenings for patients at risk for heart disease as well as full range of treatment options for women already diagnosed with heart disease care.

About Gina Lundberg

Gina Lundberg, MDGina Price Lundberg, MD, FACC, Emory Women’s Heart Center Clinical Director, is a Preventive Cardiologist with Emory Clinic in East Cobb. Dr. Lundberg is an Assistant Professor of Medicine at Emory University School of Medicine. She is a National American Heart Association (AHA) spokesperson and has been a Board Member for Atlanta chapter from 2001 till 2007. Dr. Lundberg was the Honoree for American Heart Association’s North Fulton/ Gwinnett County Heart Ball for 2006. In 2009 she was awarded the Women with Heart Award at the Go Red Luncheon for outstanding dedication to the program. She is also a Circle of Red founding member and Cor Vitae member for AHA.

She has been interviewed on the subject of Heart Disease in Women in various media channels including CNN and in USA Today. Governor Sonny Perdue appointed Dr. Lundberg to the Advisory Board for the Department of Women’s Health for the State of Georgia in 2007 till 2011. In 2005, Atlanta Woman Magazine awarded Dr. Lundberg the Top 10 Innovator Award for Medicine. In 2008 Atlanta Woman Magazine named her one of the Top 25 Professional Women to Watch and the only woman in the field of medicine.

Related Links

Emory Women’s Heart Center
Quiz – Are you at Risk for Heart Disease
Become aware of the risks, signs and symptoms of stroke
Attend a Stroke Awareness Event at Emory Healthcare
Schedule Your arrhythmia Screenings