- I had an episode 4 days before the stroke, duration 14hrs that I self corrected.
- The day before the stroke my Kardia showed NSR
- At the hospital they took a 12 lead ECG and found NSR
I'm surprised that any clots from the episode 4 days before the stroke were to blame? I don't feel that an episode "sneaked in" before the stroke, but guess its always possible. I'm wondering if there may be other contributory factors that I'm unaware? Note that I don't have any other comorbidities. Confused...
Cheers!
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Vince1001
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I don't think so. I had AF for years that clinicians ignored, as they said my high heart rate in exercise (200bpm) was due to my cardio fitness; I was fit as the proverbial butcher's dog. An EP said that I didn't need an anticoagulant in my late sixties. One day out of the blue I had a stroke. The Chair of the charity where I'm a trustee has AF; I had an email yesterday saying that she had a heart attack. From a discussion with an EP who carries out ablations, I'm not sure that they are the answer. I would say if you have AF, you should be taking an anticoagulant. As an example, the stroke took part of my vision (that's a common effect) and that meant my driving licence was revoked.
Thanks John Boy. Doesn't make sense to me... Like you my cardio said I didn't need A/C, which I obviously now have been prescribed. Spooky that I too have lost a small amount of my peripheral vision (on one side). I've done an online eye test and seem to be in excess of the 120 deg threshold. I'm awaiting feedback from the DVLA towards getting the eye test at Specsavers, which will confirm or otherwise...
You will notice the eyesight loss more on one side than the other although both sides can be affected (homonymous hemianopia) and, you will tend to look to the side that has vision loss so you won't notice the extent of the loss. If your Group 1 licence is revoked, as you have been affected after February 2020 when DVLA policy changed, you may be offered three months time to organise pre-assessment driving tuition. The assessment takes up to three hours with cognitive tests, strength and braking reaction time tests, followed by 50 minutes of driving in an unfamiliar car on unfamiliar roads. In theory the driving assessment is not the same as a driving test; however, the driving assessor would say to me, "advanced driver John would have done...". I was never an advanced driver. Despite the DVLA advising a Minister in May 2018 that time would be given for pre-assessment driving tuition, it didn't happen. I've made a submission on the subject to the All-Party Parliamentary Group on Disability, thanks to the help of Paralympian Baroness Tanni Grey-Thompson. Thousands of Group 1 (car and motorcycle) licence holders have had their licence revoked or refused, in effect a lifetime driving ban. I'll post here from time to time on this subject, as there is pressure to have mandatory eyesight testing at seventy as well.
Am very far from being an expert, but as I understand it a clot can form in the atria as they are “churning” the blood in an episode of AF but they are not necessarily expelled from the heart on the day causing a close cause and effect correlation. They can sit in the atria for a bit and for whatever reason be expelled into the circulation at a later date causing a stroke or whatever at a later date . Hope you are ok
I used to have a hard gym session then do a yoga warm down that would start with a shoulder stand, candle, plough and so on. When I had a stroke, my consultant neurologist said that she had treated someone who had a stroke during Yoga. She told me that I must not do shoulder stands etc. I suspect that I had plaque in my caroid artery that was loosened by the exercise, then detached by the neck extension.
Golly. You were fit! Personally I can well believe that explanation. It makes sense.Apart from that I think that too much exercise could be bad in the long term. Too much wear and tear on the body.
You can get an xray which shows plaques if that's a concern... Its not offered to people but you can ask for it and once you know if you have that you can help stop it getting worse ...which means you can avoid stents statins etc. I'm not sure what its called my mom is getting it done but she can't get it on HSE (Irish NHS) and has to pay for it. There's a film called the widow maker about it. And about how to minimize plaque build up. Some drugs for afib like warfarin cause hardening of the arteries as well long term ...
Keep in touch if you get your licence revoked due to the 120 degree requirement. For example, the CEO of the charity that runs the DVLA appointed assement centres, wrote that there was not general awareness (in the assessment centres) that drivers did not have pre-assessment training (and had not driven for at least 12 months). There is a peer reviewed paper that concluded the Esterman charts (the horizontal field of vision measurement) are not an adequate way of determining fitness to drive. I am in touch with a number of people including a specialist in optical medicine. DVLA have got away with this for a long time despite the Secretary of State's expert panel on visual disorders and driving, advising the DVLA Medical Group on medical issues and legislation. The complaint system is flawed as DVLA policy is not in the remit of the Independent Complaints Assessor, hence they cannot properly comment on the DVLA using a policy from 2001 until February 2020.
Really appreciate the offer John Boy. I'm very much at the early stages as I'm waiting for a ref no from DVLA in order to get the eye test. I can see this being a long haul based on your experiences/ knowledge...and its not going to be helped by DVLA having a major covid issue and threatening to strike!
Hi Vince; I started this road in 2016. I've submitted witness statements to the Technological section of the High Court in what at the time, was the largest construction claim in Europe. I would say that I know how to write submissions supported by evidence, but you wouldn't think so if you viewed the responses to my complaints to the DVLA, PHSO and ICA. However, at least the DVLA internal policy document now states that pre-assessment training must be given, so we are making progress.
When l started with AF last year and I’m 77 the Doc put me on anticoagulant straight away for this reason so l think who ever said you didn’t need them was way out of line l really feel for you my Father had a massive stroke and at the time the Sister at the hospital told me to take an aspirin every day and l always did but none of the rest of our family have l listened to her advice and thanked her .
Other than losing my driving licence after the stroke, I can exercise and work in the nature reserve as much as ever; that's down to some great work by my local hospital (Southmead, Bristol). The only scary thing is an ambulance crew who didn't know that you can have a stroke without FAST indicators. That said, I'm a "mystery patient" for medical students and, in a session with third years, none of them had heard of FAST! I'll be in Southmead Hospital on Wednesday for yet another colonoscopy, but at least Secondary NHS care really look after me.
My reasons for being in Health Unlocked are primarily to get people with AF to take an anticoagulant and, currently to a lesser extent to help people with homonymous hemianopia after an AF linked stroke, to get their Group 1 driving licence back. I still hope that the Pradaxa video where I featured can be available to the public, not just clinicians as at present.
Although rare I think a clot can form in as little as two hours. I have made the decision to stop anticoagulant's for now (only after talking to my doctor). However I have an emergency supply and a couple of hours in afib would start me on them again in a flash.
I'm not medically trained and that's just my personal take. We are all different so it's best to talk to your doctor to decide what's best for you.
Good question ! TBH I still don't know if it's the right thing I'm doing. My Chads score is zero and my cardio said it was totally my decision - I'm also in sinus. However I am of course still at risk of stroke.
I think only you can decide after talking to your doctor. A stroke from afib is no fun and will out way the risk of bleeding. It also depends on age - I know I'll be back on them when I'm a bit older. Think very carefully before deciding not to take them - I'm still 50/50 about what to do.
I haven't been diagnosed but when I read about the stroke risk and the side effects of warfarin I decided to try cayenne pepper ...I have taken it and magnesium and my afib has stopped for a week ...so so far so good for me... I can feel my circulation is better in arms and legs my veins don't feel weird and my brain fog is clearing up... I was really tired and just would go blank and have noe energy when I was having afib...it may be aflutter and afib ..since I didnot want to risk it I decided to self medicate ...I don't take a lot barely a quarter of a teaspoon. If you want to look it up it has many heart health benefits and lots of scientific studies to show it does thin blood...also doesn't harden arteries and can help to stop the walls of heart thickening over time from the fibs. If its useful then I'm just passing it on. I'm only 40 so I don't want to go down the road of the medication cascade if I can help it.
I can’t get over how much people know about their conditions l have A Fib and know something about it but not as much as what’s on here it’s frightening am thinking of coming off can’t decide if it’s better to know or not
My EP refused to put me in anticoagulants because AF was my only issue, over a few months when my AF was increasingly frequent and debilitating I was unable to get appointment with my EP (“because I was scheduled to see him in a few months anyway”), I had a stroke. Minimal residual problems. I had had afib 2 days before. Of course I switched doctors.
Vince I am only quoting cardiologists who have been good enough to talk to our support group and they say the clot forms on the heart but can be pushed out at a later date so I think your stroke was from AF. The Left atrial appendage can harbour clots easily which is why it’s checked before procedures
Hi SteelHeart...Good point. I do keep a diary of glasses of water drank per day, which is between 6 and 8 off (1.5litres min). Also I try and ensure I always drink a glass of coconut water in the morning to top up the electrolytes. I've given up tea and coffee. On the day before the stroke the water consumption was slightly down at 6 glasses, but wouldn't have thought this was inadequate - especially with the cold weather.
Very interesting idea with the diary! I have realized that I can drink beer without any problems, so usually have 2-3 beers a day. Lately, started testing wine again. If I drink 0,4 liter of wine in the before-noon, than I have to drink at least 2 liters of water in the afternoon, so also well hydrated, lol. All the best!
High potassium (coconut water) can cause afib so be careful with electryltes and get tested because if you take the wrong one it can mess you up worse. You need balance. If you have high potassium already and drink or eat a lot of potassium that can mess with muscle signals. I had high potassium when they did my bloods and lowish magnesium so I have been taking magnesium and haven't had an event since taking it. I once took a calcium tablet and because I had low magnesium my whole body went into convulsion like a cramps spasm of the entire body it was terrifying. so ya need to check out to see what electrolytes you might breed. Each of the electrolytes and water can cause palpitations and cramps ...high and low levels of most of them ...so it can be hard to tell which one you need without knowing where your levels are at. Hope that's useful.
The simple answer is that the number and duration of AF events has no bearing on stroke risk. You have AF you have risk . As others have suggested a clot can form at any time during AF and sit happily in the left atrial appendage until maybe some extra exertion forces it out into the brain.
There are many of us who believe AF should = anticoagulation unless there are very good reasons not to. There are plenty of members here who have had strokes within days of a doctor telling tehm they do not need aanticoagulation.
The duration does have a direct bearing on stroke risk from what studies I've read which isn't many... Just the main ones from a google search... The longer you're in afib the larger the risk... The risk of your heart muscle thickening and weakening also goes up the longer the duration of the illness and the longer the duration of an regent the bigger the stroke risk. The longer your blood isn't flowing the more time for blood to coagulate. So makes sense.
Yes,, for me definitely. The chambers of the heart do not pump correctly in A/F and as a consequence the blood is not circulating as it should and thats when it clots, when the heart goes back into sinus rhythm and starts to pump as to should the clot(s) are then circulated into the blood steam and can cause a blockage and consequently a stroke, I used to take soluble Asprin, 375mg a day to thin the blood due to this possibility but I still had a stroke. probably not as severe as it would have been had I not be taking Aspirin, I was hospitalised for 2 weeks but after about a year made a full recovery. I was 56 at the time and deemed to young to start anticoags, hence the Asprin. but since then I have had to take ancicoags.
My friends husband aged 50 had a stroke and crashed into a tree . He had AF but was unaware that he did. Otherwise fit and healthy guy . Pleased to say he made a very swift recovery from both stroke and car accident . Our local stroke unit is excellent .The tree not so much !
If the clot has been able to come to the brain and cause damage, it means that it was formed in the circulatory system beginning in small blood vessels in the lungs and ending, via left atrium and left ventricle, in the small blood vessels in all the tissues of the body. The only place, where the blood can have insufficient flow speed (pooling of the blood), is left atrium, not to forget left atrium appendage. If the left atrium is enlarged, the flow speed is still smaller, so, it is very likely that it is the place where the clots originate from, what the medicine is well aware of, for a long time...
Of course, it is puzzling, why the left atrium is usually enlarged and the right very rarely? If in the twin pump, what the heart actually is, the right ventricle has larger flow-rate then the left ventricle, than the pressure, generated from the right ventricle, does not decrease while the blood is flowing through the lungs ("short circulatory system"), so we have the effect of increased lung pressure and, at the same time, increased pressure in the left atrium. Having thin walls, the atrium simply stretches, giving way. Additionally, this increased inner pressure in left atrium can be very beneficial for clot formation (through bringing the platelets closer together)...
Just trying to understand and to think aloud...
in reply to
That's interesting I read recently (last night I think) about the one side thickening to create more pressure and the blood backing up towards the lings making a coughing...I don't really understand which side it is but the non lung side ...left and right I just don't brain those well. I'm taking cayenne pepper which helps prevent the walls of the heart thickening thins the blood and helps arterial elasticity ...v warfarin which causes hardening ...not that I was offered warfarin I'm not even diagnosed but I decided not to risk waiting to find a competent doctor. And very glad too...after years of worsening heart weirdness I feel better in a few weeks of taking magnesium and cayenne ...my arms and legs feel less hmmm...less awful...I can now go to sleep listing to a steady pulse in my hands and feet instead of an insane drum and base rave in my chest. Anyway doesn't seem to be a commonly used herb for relief so thought I'd mention it for anyone to research it themselves.
in reply to
Thanks for the comment! I am not a MD, but have been dealing with regulated hydraulic systems for decades, so understand the problem from technical point of view. You are right, in the case that the valve between the left ventricle and left atrium is not tight, the pressure from the ventricle, especially if the ventricle has to pump hard and with increased pressure, can lead to the increase of the lung pressure too.
So nice to hear that you have found the solution that helps with heart problems! Will keep it in mind, for certain! When being elderly (I am 68 of age), everything is allowed in an attempt to solve the health problems, including the weed, lol! Seriously, I started drinking coffee recently, despite avoiding it for the whole of my life. It has shown to be a good thing to help me wake up in the morning and to give me a little "gas", and is not against the law! The substances, contained in chilly pepper, are known to be beneficial for blood circulation, so I also started taking these strong peppers, with many meals. So far, so good! Cheers!
in reply to
Oh that's good. You're the first person on here I've met who also takes the chilli pepper! I can only stand a very small amount myself. But I think I will get used to it over time! Fingers crossed it will keep working!
Vince, I have not explored the influence of hot pepper on AF, but was going after something that could stimulate blood circulation (cold feet, cold hands, slow waking up in the morning etc.). And, I can say that I am satisfied (never expected a miracle). I would not be surprised if such strong stimulant, as hot pepper, could set AF off.
If I may tell you my opinion on AF, there are two main reasons which bring the body in AF - psychical stress and physical load. The triggers may be very different, from drinking the glass of cold water, to listening a military march in the radio, lol (somebody reported it to be a trigger). But, the triggers only set it off, when already at the edge to go into AF.
I had been very breathless for about 3 months and during that time my practice nurse and I thought my asthma was playing up and we were trying various inhalers and steroids to no appreciable effect. I then had a stroke that I was very lucky to get thrombolised and during treatment was found to have AF. So lucky as I have had no after effects from the stroke but still struggling with AF and I miss my yoga sessions so much....no I didn't do headstands but plough was fairly frequent!
From everything I've read, the stroke risk is there for everyone who has AF, but one cannot predict the other. I've no medical knowledge, so you should research with people who have. Dr Sanjay Gupta of York Cardiology is very good, and has videos on YouTube of which many refer to the stroke risk.
Vince I hope you are on the road to a full recovery.
Thank you for posting this issue as it is great to have the opportunity to discuss our layman ideas, which very few consultants will be willing to do usually due to time pressures. Having read the replies here in particular BobD 'sit happily in the left atrial appendage until maybe some extra exertion forces it out into the brain.' I am left wondering if you are not on AntiCoags whether it would be a prudent plan after short AF episodes under say 2hrs to do some moderate exercise post episode to increase the circulation rate which otherwise may pool & clot. I don't know whether this makes sense?
NB I am not medically trained and am not suggesting anybody tries this without checking with their cardiologist/EP first, just curious about the logic and always looking for a lifestyle cure.
It is really good to hear from a couple of people who have had a stroke and made a good recovery. This news represents a welcome change from the usual view expressed that every stroke is devastating. Nevertheless, having had one stroke, I certainly do not want another!
Possible. Depends on what type and strength of anticoagulant you were taking. My cardiologist suspected for years that I had afib (was being treated for cardiomyopathy and heart failure), but could never confirm with EKG. One night I woke up with transient global amnesia, a complete loss of memory that usually fades within 24 hours. Scared the hell out of my wife and I of course don't recall the episode at all, except for suddenly realizing I was in the hospital the next day. The doctors determined that episode was due to afib causing blood pooling at the the bottom of my left atria, I had thrown a small clot from the blood pool in the absence of a strong anticoagulant. Sure enough, EKG confirmed and many cardio conversions and a couple ablations later, still on warfarin. In the US, it is not uncommon to have a transesophageal echocardiography test before the procedure to see if you have any blood clots in the heart.
Yes afib is a stroke risk. When youre heart doesn't beat properly blood stagnates in the atrium of the heart and can coagulate....because its not moving constantly like a river flowing it eddies about and causes clots. That's why the first thing they do for afib is give blood thinners to lessen the risk of a blood clot forming...but a clot formed in the heart has a long journey to get to the brain. They can form elsewhere and chunks break off and travel anywhere in the body. I'm really surprised two people have said they don't think so as I pretty much only started researching afib recently and its the most common thing that comes up as the risks from afib or aflutter... So people should know this is a risk of afib. And that's that's why doctors give blood thinners for afib. And I'm surprised doctors don't inform people as this is the biggest risk of afib. And the longer you have it the more the risk as blood stagnates over time and the longer the time the blood stagnates the more likely a clot forms. Let me see if I can find some info online I honestly just googled afib and aflutter and got a ton about clots so I started self medicating immediately with cayenne pepper because I don't have a diagnosis but I wanted to reduce the risk for myself because it may be some time before i find a doctor. If you want to just google it yourself or I can look for info for you if you need. Sorry to bear the bad news but everyone with afib should be aware of this.... My mind is slightly blown that people don't know this.
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