Stroke is the leading cause of permanent disability in the U.S., striking nearly 800,000 people each year. Hemorrhagic, or bleeding, stroke is particularly devastating says Mayo Clinic neurologist and critical care expert Dr. William D. Freeman. “About 40 percent of hemorrhagic stroke patients die within a month, and half of the survivors have some type of impairment,” he adds.
Find facts and statistics about stroke in the United States.
- Stroke kills about 140,000 Americans each year—that’s 1 out of every 20 deaths.1
- Someone in the United States has a stroke every 40 seconds. Every 4 minutes, someone dies of stroke.2
- Every year, more than 795,000 people in the United States have a stroke. About 610,000 of these are first or new strokes.2
- About 185,00 strokes—nearly 1 of 4—are in people who have had a previous stroke.2
- About 87% of all strokes are ischemic strokes, in which blood flow to the brain is blocked.2
- Stroke costs the United States an estimated $34 billion each year.2 This total includes the cost of health care services, medicines to treat stroke, and missed days of work.
- Stroke is a leading cause of serious long-term disability.2 Stroke reduces mobility in more than half of stroke survivors age 65 and over.2
Stroke Statistics by Race and Ethnicity
- Stroke is the fifth leading cause of death for Americans, but the risk of having a stroke varies with race and ethnicity.
- Risk of having a first stroke is nearly twice as high for blacks as for whites,2 and blacks have the highest rate of death due to stroke.1
- Though stroke death rates have declined for decades among all race/ethnicities, Hispanics have seen an increase in death rates since 2013.1
Stroke Risk Varies by Age
- Stroke risk increases with age, but strokes can—and do—occur at any age.
- In 2009, 34%of people hospitalized for stroke were less than 65 years old.3
Early Action Is Important for Stroke
Know the warning signs and symptoms of stroke so that you can act fast if you or someone you know might be having a stroke. The chances of survival are greater when emergency treatment begins quickly.
- In one survey, most respondents—93%—recognized sudden numbness on one side as a symptom of stroke. Only 38% were aware of all major symptoms and knew to call 9-1-1 when someone was having a stroke.4
- Patients who arrive at the emergency room within 3 hours of their first symptoms often have less disability 3 months after a stroke than those who received delayed care.4
Americans at Risk for Stroke
You can take steps to prevent stroke.
From other organizations:
- Vital Signs: Recent trends in stroke death rates – United States, 2000-2015. MMWR 2017;66.
- Benjamin EJ, Blaha MJ, Chiuve SE, et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2017 update: a report from the American Heart Association. Circulation. 2017;135:e229-e445.
- Hall MJ, Levant S, DeFrances CJ. Hospitalization for stroke in U.S. hospitals, 1989–2009. NCHS data brief, No. 95. Hyattsville, MD: National Center for Health Statistics; 2012.
- Fang J, Keenan NL, Ayala C, Dai S, Merritt R, Denny CH. Awareness of stroke warning symptoms—13 states and the District of Columbia, 2005. MMWR 2008;57:481–5.
Atrial fibrillation, also called AF or AFib, is the most common type of heart rhythm disorder. People with this condition are at higher risk for serious medical complications, such as dementia, heart failure, stroke, or even death. Too many of those affected by the condition don’t realize that they have it, and many who have it don’t realize the seriousness of the affliction. All too often, healthcare providers may also minimize the effects of the condition.
September is Atrial Fibrillation Awareness Month, designated to help patients and healthcare providers learn more about this complex condition. In addition to stroke prevention, additional know-how can improve the overall wellness of those suffering from AFib. Often, those with AFib have a lower quality of life than those who have suffered a heart attack. And, unfortunately, some healthcare providers may not know about treatment options that can essentially put a stop to the condition.
For those who have AFib, seeking information about the ailment and finding early treatment are imperative. The longer someone has AFib, the more likely they will convert from intermittent AFib to enduring it all the time, making it much more difficult to stop or cure.
What is atrial fibrillation?
Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. A racing, pounding heartbeat that happens for no apparent reason should not be ignored, especially when other symptoms are also present — like shortness of breath with light physical activity or lightheadedness, dizziness, or unusual fatigue. AFib occurs when the heart muscles fail to contract in a strong, rhythmic way. When a heart is in AFib, it may not be pumping enough oxygen-rich blood out to the body.
Why is AFib associated with a five-times-greater risk for stroke?
When the heart is in AFib, the blood can become static and can be left pooling inside the heart. When blood pools, a clot can form. When a clot is pumped out of the heart, it can get lodged in the arteries which may cause a stroke. Blocked arteries prevent the tissue on the other side from getting oxygen-rich blood, and without oxygen the tissue dies.
Any person who has AFib needs to evaluate stroke risks and determine with a healthcare provider what must be done to lower the risks. Studies show that many people with AFib who need risk-lowering treatments are not getting them. Learn more about stroke risks with the CHA2DS2–VASc tool.
If I don’t have these symptoms, should I be concerned?
There are people who have atrial fibrillation that do not experience noticeable symptoms. These people may be diagnosed at a regular check-up or their AFib may be discovered when a healthcare provider listens to their heart for some other reason.
However, people who have AFib with no symptoms still have a five-times-greater risk of stroke. Everyone needs to receive regular medical check-ups to help keep risks low and live a long and healthy life. Many may experience one or more of the following symptoms:
- General fatigue
- Rapid and irregular heartbeat
- Fluttering or “thumping” in the chest
- Shortness of breath and anxiety
- Faintness or confusion
- Fatigue when exercising
- Chest pain or pressure
Are there different types of AFib?
The symptoms are generally the same; however, the duration of the AFib and underlying reasons for the condition help medical practitioners classify the type of AFib problems.
- Paroxysmal fibrillation is when the heart returns to a normal rhythm on its own, or with intervention, within 7 days of its start. People who have this type of AFib may have episodes only a few times a year or their symptoms may occur every day. These symptoms are very unpredictable and often can turn into a permanent form of atrial fibrillation.
- Persistent AFib is defined as an irregular rhythm that lasts for longer than 7 days. This type of atrial fibrillation will not return to normal sinus rhythm on its own and will require some form of treatment.
- Long-standing AFib is when the heart is consistently in an irregular rhythm that lasts longer than 12 months.
- Permanent AFib occurs when the condition lasts indefinitely and the patient and doctor have decided not to continue further attempts to restore normal rhythm.
- Nonvalvular AFib is atrial fibrillation not caused by a heart valve issue.
Over a period of time, paroxysmal fibrillation may become more frequent and longer lasting, sometimes leading to permanent or chronic AFib. All types of AFib can increase your risk of stroke. Even if you have no symptoms at all, you are nearly 5 times more likely to have a stroke than someone who doesn’t have atrial fibrillation.
How are heart attack symptoms different from AFib symptoms?
Fluttering and palpitations are key symptoms of AFib and are the key differences, but many heart problems have similar warning signs. If you think you may be having a heart attack, DON’T DELAY. Get emergency help by calling 9-1-1 immediately. A heart attack is a blockage of blood flow to the heart, often caused by a clot or build-up of plaque lodging in the coronary artery (a blood vessel that carries blood to part of the heart muscle). A heart attack can damage or destroy part of your heart muscle. Some heart attacks are sudden and intense — where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help.
People living with AFib should know the Warning Sings
As stated earlier, having atrial fibrillation can put you at an increased risk for stroke. Here are the warning signs that you should be aware of:
Heart Attack Warning Signs
Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in Other Areas of the Upper Body
Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of Breath
With or without chest discomfort.
May include breaking out in a cold sweat, nausea or lightheadedness.
Stroke Warning Signs
Spot a stroke F.A.S.T.:
- Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile.
- Arm Weakness : Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
- Speech Difficulty: Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “the sky is blue.” Is the sentence repeated correctly?
- Time to call 9-1-1: If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.
Call 9-1-1 immediately if you notice one or more of these symptoms, even if they are temporary or seem to disappear.
10 ATRIAL FIBRILLATION FACTS THAT MAY SURPRISE YOU
- AFib affects lots of people. Currently as many as 5.1 million people are affected by AFib — and that’s just in America. By 2050, the number of people in the United States with AFib may increase to as many as 15.9 million. About 350,000 hospitalizations a year in the U.S. are attributed to AFib. In addition, people over the age of 40 have a one in four chance of developing AFib in their lifetime.
- AFib is a leading cause of strokes. Nearly 35 percent of all AFib patients will have a stroke at some time. In addition to leaving sufferers feeling weak, tired or even incapacitated, AFib can allow blood to pool in the atria, creating blood clots, which may move throughout the body, causing a stroke. To make matters worse, AFib strokes are fatal nearly three times as often as other strokes within the first 30 days. And according to a recent American Heart Association survey, only half of AFib patients understand that they have an increased risk of stroke.
- The U.S. Congress recognizes the need for more AFib awareness. StopAfib.org, along with several other professional and patient organizations, asked Congress to make September AFib Month. On September 11, 2009, the U.S. Senate declared it National Atrial Fibrillation Awareness Month.
- Barry Manilow has AFib. In 2011, Manilow spoke to Congress about AFib, urging the House of Representatives to pass House Resolution 295, which seeks to raise the priority of AFib in the existing research and education funding allocation process. The resolution does not seek any new funding. Other celebs with AFib include NBA legends Larry Bird and Jerry West, politicians George H. W. Bush and Joe Biden, Astronaut Deke Slayton, Billie Jean King, music mogul Gene Simmons and Helmut Huber, the husband of daytime TV star Susan Lucci.
- Healthcare professionals often minimize the impact of AFib on patients. According to recent research in the Journal of Cardiovascular Nursing, “Compared with coronary artery disease and heart failure, AFib is not typically seen by clinicians as a complex cardiac condition that adversely affects quality of life. Therefore, clinicians may minimize the significance of AFib to the patient and may fail to provide the level of support and information needed for self-management of recurrent symptomatic AFib.”
- AFib patients may go untreated. AFib can fly under the radar as some patients don’t have symptoms and some may only have symptoms once in a while. Thus, patients may go for a year or two undiagnosed, and sometimes not be diagnosed until after they have a stroke or two. Because some health care professionals perceive that AFib doesn’t affect patients’ everyday lives, a common approach is to just allow patients to live with the condition. But…
- The quicker the treatment, the greater the chance AFib can be stopped. For those who have AFib, information about the ailment and treatment options are imperative. The longer someone has AFib, the more likely they will convert from intermittent to constant AFib, which means it’s more difficult to stop or cure.
- AFib changes the heart. Over time, AFib changes the shape and size of the heart, altering the heart’s structure and electrical system. Research at the University of Utah shows that this scarring (fibrosis) from long-term remodeling is correlated with strokes.
- Treatments continue to rapidly evolve. For years, the standard treatment for AFib patients was to send them home with medications, some of which caused harm. Now there are additional options for stopping AFib, including minimally invasive ablation procedures performed inside and outside the heart. For stubborn and long-lasting AFib, open-heart surgery may provide a cure.
- You can make a difference in an AFib patient’s life. This month, forward a link to someone you may know who could have the condition. Attend an AFib awareness raising event or webinar. Or share StopAfib.org siteand ALittleFib.org with patients and friends. Something as simple as that can help someone become free of AFib.
Prevention and Risk Reduction
Although no one is able to absolutely guarantee a stroke or a clot is preventable, there are ways to reduce risks for developing these problems.
After a patient is diagnosed with atrial fibrillation, the ideal goals may include:
- Restoring the heart to a normal rhythm (called rhythm control)
- Reducing an overly high heart rate (called rate control)
- Preventing blood clots (called prevention of thromboembolism)
- Managing risk factors for stroke
- Preventing additional heart rhythm problems
- Preventing heart failure
Getting Back on Beat
Avoiding atrial fibrillation and subsequently lowering your stroke risk can be as simple as foregoing your morning cup of coffee. In other words, some AFib cases are only as strong as their underlying cause. If hyperthyroidism is the cause of AFib, treating the thyroid condition may be enough to make AFib go away.
Doctors can use a variety of different medications to help control the heart rate during atrial fibrillation.
“These medications, such as beta blockers and calcium channel blockers, work on the AV node,” says Dr. Andrea Russo of University of Pennsylvania Health System. “They slow the heart rate and may help improve symptoms. However, they do not ‘cure’ the rhythm abnormality, and patients still require medication to prevent strokes while remaining in atrial fibrillation.”
AFib Treatment Saves Lives & Lowers Risks
If you or someone you love has atrial fibrillation, learn more about what AFib is, why treatment can save lives, and what you can do to reach your goals, lower your risks and live a healthy life.
If you think you may have atrial fibrillation, here are your most important steps:
Finding the right physician who gets your AFib, understands all the options for treatment, and will openly collaborate with you in your care is key. Use our first of its kind healthcare ecosystem to find one near you.
As a patient, you can take control of your healthcare. Go to HealthLynked.com, right now, to sign up for Free!
Dr. Fredric Meyer, a Mayo Clinic neurosurgeon discusses Moyamoya disease and what to look for when seeking care for Moyamoya disease. Visit http://mayocl.in/2ojVQI1 for more information on care at Mayo Clinic or to request an appointment.
Dr. Meyer explains this progressive disease that impacts patients of all ages. Moyamoya disease causes the arteries at the base of the skulls undergo a slowly progressive occlusion. This may cause strokes, bleeding or seizures.Symptoms, diagnosis and treatment options for Moyamoya disease are discussed.
Mayo Clinic specializes in complex surgical interventions for patients with Moyamoya disease. The multidisciplinary team at Mayo Clinic includes a neurologist who specializes in stroke as well as neurosurgeons that specialize in microvascular techniques.
If your heart doesn’t beat in a healthy rhythm, your doctor may do a treatment called a cardioversion. Here’s what to expect before, during, and after the procedure. Learn more: http://wb.md/2dGAMow
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Improving healthcare is the mission of HealthLynked. HealthLynked focuses on improving healthcare services for patients as well as physicians. Our technology shortens wait time with online scheduling of appointments, Real-time appointments by local providers and provides easy access to yours as well as your family’s updated medical records.
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My former Academy roommate had a brain tumor – an Oligodendroglioma, to be exact. The operation to remove it was a remarkable success. He was in fantastic hands at the major cancer center caring for him….and his family.
Weakened by the cancer and the operation, while at home, he fell and injured the other side of his brain opposite the tumor. When I first saw him post operation, he was trying to come out the resultant coma and could not speak. In the weeks and months that followed, speech returned slowly, and the brilliant comedic repertoire of my good friend returned along with it.
A family member had a major stroke a few years back. While almost all motor function returned to this vibrant man – He would dance up a storm and still carry on like no other – he could no longer speak. There was no “hitch in his giddy-up”, just an inability to share what was in his mind.
He used props, an always funny and sometimes inappropriate sign language of his own making, and a pad of paper to communicate with those around him. He carried pictures to tell his story – one of a strong and valiant military veteran with a lengthy service career who loved his large family, especially his grandkids.
As a result of my friend’s fall and our family member’s stroke, these two amazing men suffered from aphasia.
June is Aphasia Awareness Month. It is time to Talk About Aphasia (the Theme).
WHAT IS APHASIA ?
While Aphasia is currently impacting the lives of over 2,000,000 Americans, and the number of new cases each year is expected to triple by the year 2020, nearly 85% of people surveyed say they have never heard the term. Aphasia is a disturbance of the comprehension and expression of language caused by disfunction in the brain. Aphasia is a language disorder; a = not and phasia = speaking. It is not a speech disorder.
Some people with aphasia can understand language but have trouble finding the right words or lack the ability to construct sentences. Many people with aphasia confuse letters of a word. Others speak a lot, but what they say is difficult to understand; these people often have great difficulty understanding language themselves.
Aphasia may make it difficult to:
- Understand spoken language
- Use numbers and complete calculations
- Use non-verbal gesturing
For people with aphasia, their difficult, daily reality is being unable to share with others what is clearly churning in their mind. They struggle with understanding and producing language.
Because people with aphasia have difficulty communicating, others often mistakenly assume they have problems with normal mental function, but the person’s intelligence is almost always intact. While people suffering from aphasia cannot reach their language, cannot use the words in their language, and/or do not understand language normally, Aphasia does not affect intelligence!
WHAT IS DYSARTHRIA?
There is a difference between aphasia and dysarthria: Aphasia is language impairment while dysarthria is speech impairment. Literally dysarthria means: articulation difficulty. This may be due to coordination problems or muscle paralysis around the mouth.
Dysarthria may occur as a symptom in specific neurological disorders, for example, a cerebrovascular accident (CVA, more commonly known as stroke), a brain tumor, a brain injury, or a disease – such as Multiple Sclerosis (MS ), Parkinson’s disease and Amyotrophic Lateral Sclerosis (ALS).
A dysarthria may arise suddenly (for example, after a stroke), or gradually, in the case of a progressive disease. The muscles of the lips, tongue, palate and vocal cords cannot be used properly. Talking is unclear, monotonous, nasal and voice production is weak. One speaks with irregular intervals. In short, there is little control when speaking.
Aphasia and dysarthria may co-occur in a single patient making rehabilitation much more difficult. IN most cases where pure aphasia condition occurs, patients generally return to normal articulation compared to dysarthria patients, for whom speech will almost always be distorted.
Features of dysarthria:
- Unclear to unintelligible speech
- Change in the rate of speech, someone is going to talk more quickly or speaks very slowly and precisely.
- Monotonous voice: no emphasis
- Too high or too low voice
- The voice may sound hoarse or very soft
- Superficial and feeble respiration or very audible breathing in and out
- Accidental repetition of syllables, syllables or phrases (not to be confused with stuttering)
- The person may be heard as stuttering while they try to pronounce each syllable separately, or syllables can just blend too much.
WHAT IS APRAXIA (OF SPEECH)?
Apraxia is a disorder of the motor planning of the brain. This kind of disorder is caused by damage that occurs in the cerebrum. While Aphasia is caused by wounds on the left hemisphere of the brain making language function difficult, in Apraxia, the problem is how to control the muscles of mouth and tongue. It’s not always the same words or sounds that are challenging. The person with verbal apraxia simply struggles to pronounce words correctly.
- Aphasia is language impairment caused by stroke, degenerative diseases or head injury that damages that part of the brain where language area is located.
- Dysarthria is speech impairment that might also be caused by stroke, traumatic head injury, or even impairment from drug or a Phil use. It affects the central or peripheral nervous system resulting in weak or improper muscle control.
- Apraxia is a disorder of the motor planning of the brain making it a struggle to pronounce words correctly.
HOW DO YOU GET APHASIA ?
Aphasia usually occurs after a hemorrhage in the left hemisphere, because 90% of our language function is situated here…. Strokes that damage the frontal and parietal lobes in the right hemisphere of the brain can also cause a person to have difficulty expressing and processing language.
TYPES OF APHASIA
The terms Broca’s Aphasia (difficulty with speaking and language) and Wernicke’s Aphasia (impaired language comprehension in listening and reading) are common in diagnosis. However, the brain is complicated, and understanding the real damage done by injury is even more complicated and extensive. There is almost always a mixed picture, and many will have global aphasia.
Global Aphasia is the most severe form, applied to patients who can produce few recognizable words and understand little or no spoken language. Persons with Global Aphasia can neither read nor write. Like in other milder forms of aphasia, individuals can have fully preserved intellectual and cognitive capabilities unrelated to language and speech.
Global Aphasia is caused by injuries to multiple language-processing areas of the brain, including those classified as Wernicke’s and Broca’s areas. These brain areas are particularly important for understanding spoken language, accessing vocabulary, using grammar, and producing words and sentences.
Global aphasia may often be seen immediately after the patient has suffered a stroke or a brain trauma. Symptoms may rapidly improve in the first few months if the damage has not been too extensive. However, with greater brain damage, severe and lasting disability may result.
Damage to Broca’s region of the brain
In this form of aphasia, speech output is severely reduced and is limited mainly to short utterances of less than four words. Vocabulary access is limited, and the formation of sounds by persons with Broca’s aphasia is often laborious and clumsy.
The person may understand speech relatively well, and even be able to read, but be limited in writing. Broca’s Aphasia is often referred to as a ‘non-fluent aphasia’ because of the halting and labored quality of speech.
Patients with this disorder have problems with spontaneous speech as well as with the repetition of words or phrases. Their speech is often jerky. They also have difficulty understanding grammatical aspects of language, also called agrammatism – the inability to speak in a grammatically correct fashion. People with agrammatism may have telegraphic speech.
This is evident not only in language expression, but also the understanding of sentences. For example, the phrase, “The boy ate the cookie,” is less problematic than the more complex sentence, “The boy was kicked by the girl”. The second sentence is more difficult. If the patient is asked to repeat this sentence, he will probably say, “Boy kicks girl”.
Damage in Wernicke’s area of the brain – the region of the brain that plays a role in understanding language – is named after the discoverer Carl Wernicke. It is also called the sensory speech center and is distinctly different than the motor speech center.
In this form of aphasia, the ability to grasp the meaning of spoken words is chiefly impaired, while the ease of producing connected speech is not much affected. Therefore, Wernicke’s aphasia is referred to as a ‘fluent aphasia.’
However, speech is far from normal. Sentences do not hang together and irrelevant words intrude-sometimes to the point of jargon, in severe cases. Reading and writing are often severely impaired. Disease or damage in Wernicke’s region can lead to dyslexia and sensory aphasia.
The spoken language of Wernicke patients usually sounds smooth but lacks meaning. The Wernicke’s area is found in the left temporal lobe of the brain.
THERAPY AND RECOVERY
Aphasia is different for everyone. The severity and extent of aphasia depend on the location and severity of the brain injury, their former language ability and even one’s personality. While a full recovery from aphasia is possible, if symptoms persist long enough – usually more than six months – a complete recovery becomes increasingly unlikely.
Speech therapy is the most common treatment for aphasia. Other types of therapy have also proven effective for some stroke survivors, including:
- Melodic intonation therapy sometimes allows stroke survivors to sing words they cannot speak. Also called Speech Music Therapy Aphasia/ SMTA
- Art therapy
- Visual speech perception therapy focuses on associating pictures with words.
- Constraint-induced language therapy involves creating a scenario in which spoken verbal communication is the only available option, and other types of communication, such as visual cues from body language, are not possible.
- Group therapy and support groups
If you have aphasia:
- Stay calm. Take one idea at a time.
- Draw or write things down on paper.
- Show people what works best for you.
- Use props to make conversation easier (photos, maps).
- Use the Internet to connect to people via email or to create a personal webpage.
- Take your time. Make phone calls or try talking only when you have plenty of time.
- Create a communication book that includes words, pictures and symbols that are helpful.
- Carry and show others a card or paper explaining what aphasia is and that you have it. Keep it in your purse or wallet.
It is important to speak with medical professionals about finding speech and language therapy as soon as possible after aphasia has been diagnosed. You might use HealthLynked to find the right physician for you.
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