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Question: I recently went to the emergency room due to numbness in my right leg. It started about 4am, I woke up with this dead weight heavy feeling in one leg, like my blood circulation was being cut off in my right leg. I eventually went back to sleep and woke up a few hours later with the same mild sensation I had. I went to the emergency room because my wife and I were concerned it may be a blood clot. While at the hospital emergency room they ran an EKG, blood test and determined that my D Dimer level was 600. They diagnosed me then with ITA Transient ischemic attack (TIA, Mini-Stroke) They immediately took X-rays of my leg to see if there were any clots, this came back negative. They then took X-rays of my lungs and that as well returned negative results for any clots. They also took an X-ray of my brain and that as well came back ok. They admitted me because they wanted to run further test and have me seen by a nuerologist. The nuerologist ordered an MRI and CTScan of my head and arteries in my kneck and that as well came back negative. No signs of stroke or clots. My blood pressure while in the hospital ranged from 134/88 - 144/81 since being released I have been very anxious and concerned. From what I have read about ITA and D Dimer it has basically caused me to have anxiety and elevated blood pressure. What are your thoughts and advise? Just looking for further opinions and advise. I feel ok now just a slight headache and a bit weak but other than I'm ok. Must of what I'm feeling now is nervousness and anxiety, everytime I take my blood pressure and its higher than anything I've ever had I'm concerned.
Brief Answer:
you need to control the cardiovascular risk factors
Detailed Answer:
Hello,
it seems that you had a TIA, which is good and bad... The good thing is that TIA is transient, so you don't have any neurological deficits (or at least no obvious deficits). The bad thing is that since you've had a TIA, you're prone to stroke and in fact you have a high chance to have a stroke in the near future. That's why you have to control as much as you can what affects your risk for strokes. The blood pressure is one of them.
Do not consider a high blood pressure as an immediate risk for stroke because it isn't. High blood pressures negatively affect the arteries and cause plaque formation, which may cause strokes and other untoward events. This is not an immediate process. It takes time... Therefore you should make sure that you get your blood pressure under control but don't be afraid of transient high readings (unless they're too high of course, like higher than 200mmHg).
You should also watch your cholesterol, blood glucose and live a healthy life (including a healthy diet and a healthy body weight). The target levels for blood pressure are around 130/80mmHg, not exceeding 140/90mmHg.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
you need to control the cardiovascular risk factors
Detailed Answer:
Hello,
it seems that you had a TIA, which is good and bad... The good thing is that TIA is transient, so you don't have any neurological deficits (or at least no obvious deficits). The bad thing is that since you've had a TIA, you're prone to stroke and in fact you have a high chance to have a stroke in the near future. That's why you have to control as much as you can what affects your risk for strokes. The blood pressure is one of them.
Do not consider a high blood pressure as an immediate risk for stroke because it isn't. High blood pressures negatively affect the arteries and cause plaque formation, which may cause strokes and other untoward events. This is not an immediate process. It takes time... Therefore you should make sure that you get your blood pressure under control but don't be afraid of transient high readings (unless they're too high of course, like higher than 200mmHg).
You should also watch your cholesterol, blood glucose and live a healthy life (including a healthy diet and a healthy body weight). The target levels for blood pressure are around 130/80mmHg, not exceeding 140/90mmHg.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response. What would you consider to be the immediate threat to a stroke in the near future. When you say near future this concerns me. How near is near? I use to be a heavy smoker and under alot of stress I know that these two areas are areas I should ellimnate and control. Please provide mire clarity on near future and major contributors I should pay attention immediately to avoid a stroke in the near future. Also, what makes you believe or agree with the diagnosis of a TIA?
Brief Answer:
it depends...
Detailed Answer:
You're welcome!
The answer depends on how you want to approach this subject. With current knowledge more than 5% of patients with TIA will have a stroke later in the same year. Older data suggested an even higher percent. You may never have a stroke or you may have one tomorrow. Nobody knows or can foresee. What you can do is what I've mentioned in my previous answer and of course smoking cessation. Smoking does a lot of harm in the body including increasing the risk for cardiovascular events. I believe you didn't mention smoking at first, so I have to be more emphatic about it now that you did.
If you had to choose a single action against strokes, myocardial infarctions, etc then smoking cessation would have been the most efficient. Smoking is the absolute number 1 factor and you should definitely do something about it soon. The sooner the better. Remember that current damage from past smoking cannot be reversed. You can only stop future damage.
Regarding the diagnosis, TIA is defined as a stroke like clinical entity that resolves completely within 24 hours. No sign of stroke should be evident on an MRI for example and no neurological deficit should remain. Your description fits the definition without doubt.
Kind Regards!
it depends...
Detailed Answer:
You're welcome!
The answer depends on how you want to approach this subject. With current knowledge more than 5% of patients with TIA will have a stroke later in the same year. Older data suggested an even higher percent. You may never have a stroke or you may have one tomorrow. Nobody knows or can foresee. What you can do is what I've mentioned in my previous answer and of course smoking cessation. Smoking does a lot of harm in the body including increasing the risk for cardiovascular events. I believe you didn't mention smoking at first, so I have to be more emphatic about it now that you did.
If you had to choose a single action against strokes, myocardial infarctions, etc then smoking cessation would have been the most efficient. Smoking is the absolute number 1 factor and you should definitely do something about it soon. The sooner the better. Remember that current damage from past smoking cannot be reversed. You can only stop future damage.
Regarding the diagnosis, TIA is defined as a stroke like clinical entity that resolves completely within 24 hours. No sign of stroke should be evident on an MRI for example and no neurological deficit should remain. Your description fits the definition without doubt.
Kind Regards!
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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