Cardiovascular Conditions: Stroke Flashcards
Ischemic stroke caused by
thrombus (clot) in brain = non-caridoembolic (meaning not form in heart)
embolus (clot) forms in heart and travels up to brain = cardioembolic (common cause by AF)
87% of strokes
Hemorrhagic stroke is….
bleeding in brain
often by intracerebral hemorrhage or subarachnoid hemorrhage
13% of strokes
Transient ischemic attack
TIA = mini stroke
cause by temporary clot, symptoms resolve in minutes/few hours
often warning sign for acute ischemic stroke
Modifiable stroke risk factors
HTN = most important
Afib
Dyslipidemia
Diabetes
Physical inactivity
Smoking
Non-modifiable stroke risk factors
Prior stroke or TIA
Age > 80yrs old
Race (higher in AA)
Genetic disease (sickle cell)
F.A.S.T
Face dropping
Arm weakness
Speech difficulty
Time to call 911
Fibrinolytic drug FDA-approved to treat acute ischemic stroke?
Alteplase
Pts candidate for Alteplase if…
no bleeding seen on brain imaging and….
Stroke symptom onset < 4.5hrs per guidelines, <3 hrs per FDA
admin within 60min of hospital arrival
doesnt have contraindications for Alteplase
Alteplase Contraindications
Active internal bleeding
hx of recent stroke
Severe uncontrolled HTN ( > 185/110)
LMWH w/in 24hrs
DOAC w/in 48hrs
Warfarin + INr > 1.7
Blood glucose < 50
Aspirin for prevention of early recurrent stroke
81-325mg PO QD start within 48hrs after stroke onset
** not given within 24hrs of fibrinolytic therapy **
Prasugrel is contraindicated to anyone with history of
TIA or stroke
Should DAPT be used long term for secondary stroke prevention?
no
inc risk of hemorrhage
ER Dipyridamole/aspirin (Aggrenox) interchangeable with individual components?
No
Drug of choice in stroke/TIA if contraindicated or allergy to aspirin
Clopidogrel
Treating elevated intracranial pressure
Admin osmotic therapy with either hypertonic saline or mannitol
