This is Med Talk presented by HCA Midwest Health. I'm Jayme Monacelli with Dr. Ameet Deshmukh, emergency medicine physician and we're talking about stroke. Stroke is no longer an old person's event - sign and symptoms. Thanks a lot for joining us, thank you for having me, Dr. district. Let's talk about the beginning. What exactly is a stroke? A stroke is usually an event that affects the brain, tissue, it affects the blood flow to the brain, its cause, it's either caused by an interruption, and blood flow to the brain, or a emerge or a bleed in the brain itself.

It's a time sensitive diagnosis, for treatment and it can be devastating in disabling and lead to death also for those who don't know why should the word stroke be in everyone's vocabulary regardless of how old they are.

We're seeing an increasing incidence of strokes in a younger age all below the age of 45. Now, people need to know the signs, initial signs of stroke so they can act fast. The mnemonic that the American Stroke, Association has is the mnemonic is actually FAST at looking at facial droop, arm weakness, speech interruption, and the T is time, so call right away to activate 911 EMS. Don't try to drive the person or the loved one, or by standard when you see to the hospital. So we always associated having strokes with our parents or grandparents, people that are older and not younger. But it sounds like that's not always the case.

That is true. We're seeing an increasing incidence of diabetes, obesity, hypertension, tobacco abuse, people don't take care of themselves quite as well as they used to, and we're seeing an increasing incidence of strokes and younger folks these days.

So knowing that, now let's talk about some of the signs or the symptoms of stroke. So our listeners know exactly what they should be looking for, or what they should be feeling that would be signs of a stroke. Can you talk about that?

So any time you see anybody with an acute or a rapid onset of confusion, if you look at their face, and you can easily ask them to smile, if you notice any irregularity and their smile one side may be higher than the other, if you notice, they can't blink their eyes very well, or stick their tongue out if you notice they have any weakness in their arms, or they say their arms or numb or their legs are numb or they have difficulty walking or holding some things.

Some people will present just with a...

I can't hold my pen. Well, when we know a case of a physician here in town within the last 10 years, it presented with that type of symptom. So there are many, many, many symptoms that you can have, but the most obvious ones are weakness.

Are the symptoms immediate and do they last for a while?

So it depends. There are mini strokes, which we call TIA and actually, more permanent strokes called CVAs.

And the difference is that the TIAs are temporary events where you may have weakness in your arm or leg, or face, or difficulty with your speech. And it may last under 24 hours anywhere from a few minutes to several hours but it is not a permanent type of it.

My understanding is that some people actually have other health conditions that may put them at a higher risk for a stroke but may not know that.

Definitely, definitely. So, we do often find patients in the emergency department setting that come in with undiagnosed hypertension, they have coronary artery disease, or plaque built up and in their arteries over time, they also can have diabetes it's un-diagnosed you can have folks with a mid-A hole in their heart called basically, they have abnormalities in their heart that need to be fixed at over time, they've never had diagnosis of that, they've never had an ultrasound, their heart, people will have anomalies or abnormalities of the blood vessels in their neck going to their brains, folks gonna have aneurysms and their brains to... So part of this is part of development in general. We're all similar but not the same.

Are those things that would come up if you're going to get a regular physical... Are those things that doctors are gonna be checking for, in a physical... It just depends if you're having symptoms of any weakness or headaches or numbness in your extremities, those are things that your doctor may check for tell me what someone should do if they think that they've got some of those risk factors that you mentioned or in fact if they notice, they are experiencing some of those symptoms, I would definitely go to your primary care physician if you're having things that are happening over time, they can refer you to a neurologist or cardiologists. We have some excellent ones in the system, they can do testing like MRIs of your brain, they can do ultrasounds of your neck, we can do ultrasounds of your heart, we can do all kinds of things to look for those risk factors or any of those congenital or born with abnormalities that can predispose you to this.

At what point do you call 911 and why is that so important? If you think you might be suffering a stroke, if you notice an acute change - when we say acute we mean a rapid onset of change. So, If I woke up this morning and I came here for this podcast and all of a sudden I'm talking to you and you looked at me and my face looked a little funny or I felt numb in my arm. I should call 911 or you should call 911 for me.

Is there anything else that people should know about strokes? And how it's no longer just for an old person's event.

I think the most important thing is primary prevention, just like any cardiac type disease, healthy lifestyle avoid smoking good exercise, low fat diets just generally taking care of yourself helps prevent strokes in general.

And I think young people, kind of like we've done with the cardiac thing with the AEDs, or you've seen the defibrillators all over the place you see them in at the mall, you see him at the kid schools, they're all over the place.

I think time is tissue, with heart disease in...

Time is tissue with stroke. So the faster we can intervene on these through an emergent just from an emergent standpoint, the more likelihood we have to save a life. Or to decrease disability or later, long-term effects of those events.

Well, thanks a lot for your time today. Dr. Ameet Deshmukh, the stoke emergency medicine physician. This has been Med Talk presented by HCA Midwest Health. I'm Jayme Monacelli.