Stroke-Rothrock Flashcards
What are some important risk factors for stroke?
Age HTN Diabetes Hypercholesterolemia Cigarettes Afib; mechanical valve asymptomatic carotid artery stenosis migraine prior stroke or TIA (most potent) patent foramen ovale
Why is a fib a risk factor for stroke?
left atrial appendage.
afib–clots break off–>travel thru L ventricle & into the aorta
can cause an embolism to the brain
Which artery in the brain usu clots w/ an embolism?
middle cerebral artery-artery of embolization. straight shot up the aorta. common carotid–internal carotid–middle cerebral artery
Why are mechanical valves a risk factor for strokes?
mechanical valves cause platelet aggregation
emboli form & can pop up to the brain
Why is HTN a risk factor for stroke
HTN–>promotes brain aneurysms and atherosclerosis & hardening of large arteries
What are the primary prevention goals for stroke?
HTN Diabetes High Cholesterol Cigarette Smoking Afib, mechanical valve migraine w. aura (more minor) patent foramen ovale (no evidence that closing it will reduce stroke risk) ACAS: asymptomatic coronary artery stenosis (very minor)
Why is diabetes a risk factor for stroke?
diabetes promotes atherosclerosis of blood vessels b/c of the agitation of the extra blood sugar
What are the secondary stroke prevention strategies?
carotid endarterectomy or angioplasty
antiplatelet therapy, statin
chronic anticoagulation
Why is smoking a risk factor for stroke?
smoking makes your blood pro-thrombotic
when you stop smoking, almost immediately decreases risk for stroke
long term: increases risk for atherosclerotic plaques to form
Once again, what does the CHADS2 score stand for?
Congestive Heart Failure HTN Age over 75 years Diabetes 2 points for previous stroke or TIA
Why is it not such a good idea to do screening for asymptomatic coronary artery stenosis?
b/c many people even with 70% stenosis have a 2% risk for stroke.
after a surgery–>50% relative risk reduction, but only 1% absolute risk reduction.
have to perform an expensive procedure on many patients just to save 1 life.
T/F There really isn’t an indication for a coronary endarterectomy unless symptoms are present.
True.
T/F You should prescribe a statin to a patient after a TIA even if their cholesterol is in normal levels.
True.
