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Invisible defect could cause a stroke

September 22, 2008 12:00:00 AM PDT
Heart disease is the third leading cause of death in the United States, and kills twice as many women as breast cancer every year. Even if you're young, healthy and active an invisible defect may leave you at risk for a stroke. Twenty-eight-year-old marathoner Nicki James never imagined she's have a stroke. But two years ago, one knocked her off her feet.

"My fiancé came in and asked me what was the matter, and at that point I couldn't talk," said Nicki James, who suffered a stroke.

She was in church when she felt the right side of her body go numb.

"I had another friend that came up and she just had tears in her eyes, and I knew something was wrong at that point so I started to get upset," said James.

Getting to the ER fast saved her life.

"In a stroke, every minute is important," said Dr. David Chiu, Eddy Scurlock Stroke Center Methodist Neurological Institute.

By morning, Nicki could walk again. Her stroke had been caused by a hole in her heart called a patent foramen ovale, or PFO.

"It freaked me out because I've had it for 28-years and I never realized, you know, that's, I never realized I had it and that was the cause of this," said James.

New treatments are saving young women's lives by targeting PFO's.

"The million dollar question is what's the best way of preventing a second stroke from occurring?" asked Dr. Chiu.

A procedure called star-flex -- a clamshell-like device is inserted through a catheter into the heart. Half of the device closes on the right side of the wall between the left and right atrium, the other half closes the left side, sealing the hole.

"If the trial does show what we suspect, it will become approved," said Dr. Chiu.

Nicki had none of the traditional risk factors for a stroke. Some signs you might not know about -- trouble smiling or a sudden severe headache, also, daytime drowsiness and insulin resistance, even in non-diabetics could all be warning signs.

Luckily for Nicki, she got help fast, making her stroke only a bump in the road.

Stroke is not only on the rise in young women. In recent years, strokes have tripled among middle-aged women. This has happened despite an increase in use of cholesterol-lowering and blood-pressure-controlling medications -- steps that should lower stroke risk.

Web Extra Information: Aren't I too young for a stroke?

WHAT IS A PFO? The Patent Foramen Ovale, or PFO, is a small hole located in the atrial septum that is used during fetal circulation to speed up the travel of blood through the heart. Normally, the foramen ovale closes at birth when increased blood pressure on the left side of the heart forces the opening to close. PFO occurs in about 25 percent of the general population. In patients who have stroke of unknown cause (cryptogenic stroke), the prevalence of PFO increases to about 40 percent. This is especially true in patients who have a stroke when they are younger than 55 years old.

SPOTTING A STROKE: Every year, about 700,000 people suffer from a stroke. For 500,000 of these people, it's their first stroke, and for about 200,000 it's a recurrent stroke. Physicians at the Nevada Neuroscience Institute came up with three simple questions to determine if someone is having a stroke. 1.) Can you smile? 2.) Can you raise both arms? 3.) Can you speak a simple sentence?

If any of these functions can't be easily performed, call 9-1-1 immediately. Catching a stroke early can not only save a persons life, it can also make their road to recovery much faster. David Chiu, M.D., director of the Eddy Scurlock Stroke Center at the Methodist Neurological Institute in Houston, Texas, told Ivanhoe, "In an average stroke, in the first few hours, two million neurons, nerve cells, die per minute." This makes time a crucial determinant in the outcome of a stroke.

NEW STROKE PREDICTORS: Recently, doctors have been predicting stroke risk in some unsuspecting ways. Several studies have been done looking at these stroke predictors. Higher stroke risk has been seen in women with artery buildups that are revealed during a routine mammogram. Non-diabetics who start to suffer from insulin related problems might also be at a greater risk for stroke. Frequent dozing has also been associated with an increased risk in stroke. The odds of having a stroke may be up to five times greater for heavy dozers, and three times greater among occasional dozers.

 

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