Was it a TIA?

[DonnaA]

Hi all, recently had a suspected TIA nearly 3 months ago. I got home one night and went to lock the door and I couldn’t get the key in the lock. I had no pain, no disorientation or confusion, no blurred vision, no pins and needles or numbness, no slurred speech, my left arm just felt a bit heavy. I immediately had thought stroke, tried lifting both arms, left arm felt heavier and I could clench both fists. I don’t smoke, don’t drink, watch my diet but I am about 2 stone overweight.

I rang my daughter and 111 immediately. Paramedics showed up, did a few tests, everything normal but I went to hospital same night. Bloods and CT scan were normal. I was told it hadn’t presented like a classic TIA, my blood pressure wasn’t as high as they’d expect for a stroke or TIA and I was given 300mg of aspirin, told to take 75mg of aspirin per day from here on and sent home with an appointment with the stroke department.

Went to the stroke department, had a neck ultrasound which was normal and was told again that it hadn’t presented like a classic TIA, but they wanted an MRI scan.

It took about six weeks to get the MRI scan. MRI scan showed nothing, everything was healthy as it should be and great for my age. At a further appointment a month after the MRI, I was told that they couldn’t say for definite if I’d had a TIA or not, given TIAs leave no damage and the fact it wasn’t a classic TIA or presented how TIAs usually present. However, they said they were treating this as a TIA based upon my risk factors, my risk factors being over 55, (I’m 58), overweight, cholesterol level of 5.4 at that point, (cholesterol level is now 5.1 and no bad cholesterol), raised blood pressure on two occasions (blood pressure is fine at home, often as low as 110/70), ex smoker (I quit 10 years ago), they were advising statins and a blood thinner.

My dilemma is, what if this wasn’t really a TIA, what if they are wrong. And I’m not relishing starting on medication for life, if it’s been a false call. I’m still taking the aspirin, but haven’t started the medication yet which has now been sitting in my cupboard for a week.

I just don’t know what to think or do for the best.

Sorry this is long.

[10gingercats]

I had something that more resembled a stroke than yours but the cardios said in my case it had been more likely been an embolism.Like you nothing strongly significent showed up as for stroke but they were suspicious. I am not a medic so this is based entirely upon my own experience. So I guess strokes come in different ways is what i am saying.They later found I had a hole in my heart,which was news to me, and promptly closed it to avoid a further TIA?or embolism.I decided to take the recom. Apixaban as I did not want to risk a stroke in the future.

[DonnaA in reply to 10gingercats]

Yeah that’s it, everyone is different. Just because it wasn’t classic TIA, doesn’t mean it wasnt and I guess that’s the way they are looking at it. I felt totally fine, I just couldn’t get the key into the lock. It was like my hand just froze and wouldn’t move. But other than that, nothing at all. I mean I’m reading other stories and each one I’m reading they all had other symptoms alongside the heavy arm, so my case is unusual.

[Happyrosie]

so I think you need to discuss this again with someone who has access to your family and medical history. Just to talk it over with someone who can point out the ifs and buts. Assuming you are in the UK, your doctor’s group of surgeries probably employés one or two pharmacists and that could be an ideal person. Your receptionist would know,

Medicine isn’t always cut-and-dried, it could be that no-one knows and no-one will ever know.

In the meantime, think carefully about your diet and lifestyle, giving tweaks when necessary.

[DonnaA in reply to Happyrosie]

Hiya, thanks for reply. I do already eat healthily and have been for some time. My cholesterol level in 2020 was 6.9 and after living on food deliveries from Iceland during lockdown. I managed to get my cholesterol down from 6.9 to 5.8, then from 5.8 to 5.4. Had a cholesterol test a couple of weeks back as I wanted to know my cholesterol level now after losing over a stone and before committing to statins and it’s 5.1 now, bad cholesterol practically non existent. So if my diet was unhealthy, I suspect I wouldn’t have got my levels down by 15 points. ……As for lifestyle, I’m pretty active, always do 15,000 steps per day, I also work.

Already had a chat with my doctor last week and he says I’m best off taking medical advice. They don’t know and of course we will never know, but they can’t just brush it off that it wasn’t a TIA either and he says despite my lower cholesterol level they’d still advise statins, etc.

[TedSpaniel]

My experience was a couple of years ago I came over very dizzy, everything appeared to be melting. It just came on from nothing. I was at work and managed to walk, albeit very wobbly, even with grabbing a bench in the workshop. I got myself out into the fresh air and sat down. Next thing I have First Aider panicked getting me laying down, Defib by my side and an ambulance on the way. Taken to A&E and after being seen it was diagnosed as either a T.I.A. Or something wrong with my ears. I had test after test and nothing was wrong with my ears.

After that I was experiencing ectopic beats. So off to the G.P. With Apple ecg printouts and was referred to hospital. They did a load of tests and again nothing, all very frustrating as I knew something was wrong. So last April I woke up feeling absolutely awful. Went to A&E and finally they caught it, A Fib. A cardio version latter and a load more testing and turns out that that episode was more than likely a T.I.A. My wife was at the time on a heart ward, a consultant looked at my notes and his opinion was I was lucky I got to the hospital when I did ! Totally see your point on classic TIA symptoms and signs, they ruled it out at the time for me as no speech issues, no issues with arms etc etc.

Cholesterol wise I was diagnosed since then with it being high, 9 months of statins later a further test said it hadn’t improved so double dose ad another blood test due the end of this month. I am over weight and working in that one. But have experienced terrible anxiety which hasn’t helped.

Satins wise they give them out to everyone over a certain age and it’s almost recommended now. High cholesterol isn’t always the fact someone is over weight. My mother in law was way under weight and add high cholesterol and her diet was a very good one with no processed foods.

Meds are just one of them things where sometime trying different ones is needed. Speak to your GP or pharmacist is you are experiencing issues. Keep going and talk to these people, it’s their job !

[DonnaA in reply to TedSpaniel]

Hi, thanks for sharing. Mine happened walking back from work late at night. The weather was really blustery, gale force wind and raining heavily. I was trying to fight the weather with my umbrella and being over a stone heavier then, was breathing pretty hard. It happened when I arrived home and went to lock the door. I live alone, so it was pretty scary despite no other symptoms.

That has actually happened to me before, coming over all wobbly and my legs feeling like jelly, however for me it was my ears. MRI was sound, so I’ve obviously had no strokes in the past or anything. I too get ectopic beats and I’ve been getting those since age 26, 32 years now, however having been on an ecg numerous times and an echocardiogram twice, that too was normal and just how my heart works, I was told. No hole in the heart. No a-fib either, none that has been caught. I have an Apple smartwatch and that has never caught anything either. I do have bradycardia and my pulse is often always in the mid 50s dropping to as low as 40 in my sleep. But I’m pretty active too.

Another thing I’ve observed, is that many who have had TIAs say they experienced migraines with aura, well I get that too. I don’t get migraines often, but I always know when I’m about to get a migraine as I get blurred, greyed out tunnel vision. I drink more water these days to try and help avoid them.

I’m not to keen on taking medication of any kind. Statins and blood thinners for life in my case they say, despite I had no other symptoms and no high blood pressure, or high cholesterol. I asked if I could just remain on aspirin and was told that although it would be a reasonable alternative, I’d be going against medical advice. But aspirin was good enough for 3 months and while they were doing tests, which all showed nothing wrong.

I think I will just make another appointment for a second opinion from my local surgery. I just feel like I’m being a pest.

Thanks for taking the time to reply.

[aardvark68]

Hi DonnaA. From what I’ve read in the literature, the purpose of the medication is not just to reduce cholesterol but also to stabilise plaques. So whether or not they are certain you have had a TIA, they may consider that it’s better to take the medicine to prevent the possibility of you having a major stroke in the future. Like the other replies mentioned, perhaps you could discuss this further with your medical team.

[DonnaA in reply to aardvark68]

Thanks for the reply.

Don’t the plaques have more chance of breaking off if the blood pressure is high though? I watched a video that mentioned this and no significant plaque build up was noticed from the neck ultrasound, not that that is a reflection of other areas I suppose.

[TheBearB55]

Cannot really answer your questions, but having had a TIA and HA in 2019, I'm now on "meds for life" and its not something to be concerned about once you get the right balance.

Just include them in your daily routine and you almost forget about the minor inconvenience -really!🙂

[DonnaA in reply to TheBearB55]

Thanks for the reply.

They’ve given me 40mg Atorvastatin and 75mg Clopidogrel. I’m not keen on taking either, but if I must, I’ve got no choice. I think I might try getting the statin reduced to lowest dose though, I’ve heard bad things about the higher doses.

[TheBearB55 in reply to DonnaA]

I've been on 80mg Atorvastatin for several years. I had the same qualms as you regarding Statins, but Atorvastatin is apparently, the "next generation" and does not have the same side effects as the older ones. It's the only way my Cholesterol stays under control.

I'm also on Clopidogrel 75mg and others - life goes on!

Be sure to get annual blood tests for liver and kidney functions.

[fishonabike]

although you give plenty of detail about your event I am not clear about what you want help with, so it is difficult to offer useful suggestions

have you thought of contacting the British Heart Foundation Helpline? the staff may he able to direct you to more useful sources of info if they can't help

[RoyMacDonald]

Hi DonnaA

Neither Statins or Anticoagulants have side effects for me so if that's the same for you I would take them because you cannot recover from a stroke to the same as you were before so better to be safe than sorry like me. Also aspirin increases stroke risk severity due to its effect on bleeding. I can't believe they intended you to take it long term. But I'm not qualified in heart medicine.

All the best

Roy

[DonnaA in reply to RoyMacDonald]

Hi Roy and thanks for the reply.

I don’t think they meant for me to take aspirin long term, it was just advised until they got to the bottom of why I had a strange turn, which took a while as I had to wait a few weeks for an MRI, then 3 weeks further for the follow up from the MRI. 15 April is when I was told I needed medication for life, based upon risk factors for a future stroke, which didn’t kinda make sense to me given I have not got high cholesterol, no high blood pressure, I’ve lost and am losing a lot of weight, I don’t smoke, etc, etc.

Currently taking 75mg of dissolvable aspirin per day until I figure it all out.

I hear what you are saying though and thanks,

[RoyMacDonald in reply to DonnaA]

I commented on the aspirin because my Doctor has a fit if I suggest she prescribes aspirin for me. Only I sometimes use the wrong word as my stroke affected my speech so I sometimes say aspirin when I mean paracetamol which I take for my back pain to get to sleep. I'm allergic to co-codamol unfortunately. Makes me throw up big time.

All the best.

Roy

[cariad67]

Hi Donna , I had a bad TIA in 2009 , I'd had a very stiff neck for 3 days which had got better , then I woke up & went to the kitchen & my right arm just was'nt doing what I wanted it to do , it felt weak & as if it just could'nt grasp anything properly , I went back to the bedroom to tell my husband , I noticed my leg had gone weak by then & when i began to speak I started speaking like a tape recorder on fast forward .. yet in my head I was speaking perfectly "very scary stuff" I became frustrated as my husband was just sat there gobsmacked ! & shouted whats happening to me!!!! then again I shouted " I think I'm having a stroke!! ... all in fluent gibberish!...then the next sentence came out properly , all in all it lasted about 25 minutes , We rushed to the hospital where they kept me in 11 days & did every test imaginable , my cholesterol was 2.8, BP was 120/70 . I'm overweight but the consultant told me that , that alone would not cause me to have a TIA .. the only thing they found on the MRI was that i have cervical stenosis & arthritis in multiple levels of my neck & said maybe that had caused compression on a vein which built a small clot up?... then I was put on 75mg of aspirin which I take daily , moving forward to 2017 , I had a CT guided colonoscopy & by chance they saw I had a rare malformation called an AVM in the right lower lobe of my lung , I was operated on within 2 weeks as this is very likely to cause strokes .. So I'm still in the dark as to what actually caused my TIA , but the doctors seem to think it was highly likely that it was the pulmonary AVM ... I'd certainly question taking statin's for a cholesterol level of 5.1 & ask why they think you need an additional blood thinner as your already on aspirin ? have they done a blood viscosity test & its been raised? .. please ask questions , all the best & hope you get some clarity soon x

[DonnaA in reply to cariad67]

Hi and thanks for the reply. Yes it’s very scary and scarier with combined symptoms I’d imagine. I was scared and despite for me it was just a case that I couldn’t lock my door. It was an odd feeling not being able to do something that otherwise comes naturally. I could still feel the keys in my hand, no numbness, no tingling, just like a heavy feeling. I could lower my arm and could lift it to the lock again for a second attempt to lock the door, but it was like it was stuck in that position and I couldn’t move it towards the lock. Strange thing is though and shortly after, I was able to pick up my phone, hold my phone, etc, so it probably only lasted a matter of five minutes or even less than that. Regardless I was in panic mode and immediately thought stroke. At that point, I’d never even heard of a TIA. I took no time in phoning paramedics and they showed up probably an hour and a half later.

You know I’ve questioned the statins, they know I’m not keen on taking them and particularly when I can manage my cholesterol through diet and have proven I can. I’d insisted on another blood cholesteral reading before I committed to medication, as he was basing my cholesterol risk factor from a reading of 5.4 taken two years ago, when the bad cholesterol was a touch higher than it should be. He said that was a good idea, but regardless, even if my new cholesterol reading was low, he’d still advise statins.

Anyway, my latest score of 5.1 is normal, so it’s gone down again. No significant high amounts of bad cholesterol this time around. My diet now is basically Mediterranean. I’ve been eating pretty healthily since 2020 and I discovered my cholesterol level was 6.9. So I think I have done pretty well to get it down to 5.1.

I went to see my GP last week with concerns. He said basically same thing as consultant in regard statins. I mentioned the blood thinner and he said that although Clopidogrel and Aspirin are basically the same, Clopidogrel is a bit better…….it’s my choice whether I choose Aspirin over Clopidogrel he said.

And another GP will probably say the same.

It would be so much easier if they could pinpoint why it happened and some test revealed something, not that I’m wishing myself ill but at least I’d have answers and that it definitely probably was a TIA.

[cariad67 in reply to DonnaA]

yes very frustrating .. but regardless of whether it was or was'nt a TIA try not to get too anxious about meds ... ive taken aspirin since im 40 years old "17 years" & it does worry me occasionally because i have gastric problems but ive never been offered any other alternative... that said there's swings & roundabouts with all medications & maybe they will put me on Clopidogrel soon ... good luck with your doctors ... take care

[DonnaA in reply to cariad67]

So they didn’t give you statins?

I’m wondering why some get recommended statins for TIA and some don’t. Why aspirin is recommended for some, while others are advised blood thinning drugs.

Even if I had a TIA, it was mild, a lot milder than some get them, yet they want me on two medications. Just not understanding it at all.

[cariad67 in reply to DonnaA]

no statins as my cholesterol was only 2.8 .. just 75mg of aspirin ... the doppler scans on my carotid artery were clear , so no need ..

[DonnaA in reply to cariad67]

I’m surprised no statins because it’s not just about the cholesterol level according my pharmacist, but about stabilising the plaque which can break away in the arteries and form a blood clot. They can’t pinpoint why it happened to me, so they are just guessing at why it may have happened and arterial plaque is their go to reason I guess. The scan on my neck showed some plaque, but no significant build up……the guy who did the ultrasound said it was normal. But anyway, took my first statin at bedtime last time and aspirin this morning. Just hope I get no side effects from it.

[Kiki54]

I had several T.IA's but didn't know that's what they were at the time . I had weird dizzy turns and it felt like my eyes were trying to cross. They only lasted a few minutes. Fast forward to 6 mths later. I temporarily lost the vision in one eye. It was like a grey roller blind being pulled down . I was send for a doppler scan. No

blockages were found but they did say my heart rate was rather fast. I got an E.C. G and also an Echo. They discovered I had a leaking Mitral valve with regurgitation and stenosis. Apparently my heart valve was damaged in childhood due to Rheumatic fever.

Might be worth asking for an Echo ?

I'm getting a valve repair as its now at severe level. I know OHS for a valve replacement is on the cards but because I'm only 54 , they want to try the repair first as I don't want a metal valve and have to go on Warfarin.

Keep us posted and good luck !

[DonnaA in reply to Kiki54]

Hiya, thanks for reply. I’ve already had two echos in the past, one as recent as Feb 2021. They say there is nothing wrong with my heart, despite I get ectopic beats. I had episodes of tachycardia early 2023 and requested another echo, but they refused to give me one and threw Bisprolol, spelling? at me instead which I only took when needed. I don’t get tachycardia anymore, but now it’s bradycardia. I was on a holter monitor for 24 hours last week because of Bradycardia and my pulse dropping to 39 bpm during sleep. It doesn’t happen all of the time, but my smartwatch has picked it up 3 times. They also wanted to check for A-Fib. Not the first time I have been on a holter monitor either, but nothing is ever picked up.

Hope everything goes well for you!

[Kiki54 in reply to DonnaA]

Thank you! I started getting symptoms from my Heart 7 years ago ( about a year before I started having T.IA's. I've been on 75mg Clopidogril ,20 mg of Atorvastatin, and 40mg of Furosemide ever since. I naturally have very low blood pressure and can't take any beta blockers like Bisoprolol as I have asthma and copd.

If you don't have high blood pressure or heart issues, then why have they put you on a beta blocker?

I also had to wear a heart monitor for 5 days to check for AFib( which I don't have)

Is 24 hrs of wearing a heart monitor enough to get a true reading?

Also considering your cholesterol reading? Ask why you are on 40mg of Atorvastatin ?

I've had no issues being on 20mg and defo feel safer on clopidogrel than aspirin.

Lots of questions for you to ask .

I hope you get a detailed response from your Dr's or Consultant

Kiki 🫶🏽

[DonnaA in reply to Kiki54]

Hiya, they gave me beta blockers because I was having an issue with fast heart rate at that time, so it was to slow my heart rate down. I only took the Bisprolol when I felt I needed it though, didn’t take it every day and no longer take it now. The heart consultant had advised them because they weren’t prepared to give me another echocardiogram having had one in the past 3 years. They say there is nothing wrong with my heart. I lost my mam in 2022 and my brother in Dec 2022, so I often wonder if the tachycardia started because of grief because it started to happen at that time. The doctor told me I’d be on Bisprolol for life and I didn’t need to be on it for life because the episodes only lasted three months then just disappeared. I’ve had no problem since. So he was wrong about the medication and needing it for life.

I don’t think 24 hours is enough to get a true picture either, but that’s all I got. At one point they were refusing to even give me a holter monitor, because as I said, they say there is nothing wrong with my heart. I only got the holter monitor this time because of bradycardia and stroke consultant requested a heart trace to check for A-fib. Still awaiting results of that.

But I’m phoning for an appointment tomorrow to see a different GP and going to ask these things. And why they’ve given me 40mg. Id be happier on the 20mg. I was talking to the pharmacist earlier and she thinks it’s a bit odd, but said they were probably just being cautious.

Medication is something I know I will have to take. It could well have been a TIA and I can’t leave it to chance that it wasn’t. I don’t want to take medication especially for life, but I don’t want to risk any further episodes either.

Meantime I’m focusing on losing more weight.

Thanks for listening

[DonnaA in reply to Kiki54]

Hi Kiki, Just letting you know that I managed to speak to a pharmacist this morning, there was no doctor available for appointments at the surgery today. I enquired why 40mg of Atorvastatin and she said it was guidelines for people who have had recent strokes/TIA and at this point it’s more about stabilising plaque, but if I was more comfortable starting on a lower dose 20mg to see how I go, she’d do that for me. She’d also said my bad cholesterol levels were only very slightly raised, nothing alarming, but that it’s not just about levels.

I actually got far more sense and understanding out of her, than both the stroke consultant and doctor.

So I will be starting the statins later today, best taken at night so I’ve been reading, along with aspirin for now. Hopefully it will suit me.

Hope you have a good day

[Kiki54 in reply to DonnaA]

Hi Donna, I'm glad you got some answers. Pharmacists are amazing. I think it's good to see how you get on with 20 mg. No point being on 40mg if you don't need it.I take mine at 10 pm. I'm a bit of a night owl.

Make sure they do some blood tests in a few weeks to test your liver function. I tolerate it well but not everyone does.

Good Luck!

Kiki 🫶🏽

[Shabana1974]

Hi Donna

Basically a TIA is a mini stroke (Temporary blockage) my husband has and several. And in my experience by the time they do scans, mri it's pointless because the blockage as cleared by the time you get to hospital. I went to the hospital the first 2 my husband had. But now by the time we realise he's having a TIA it's cleared up. (My hubby had a catastrophic stroke) in 2021. So he's very Anti hospital having to stay while he recovered to a he could come home. But to call ambulance, they take to hospital do all the scans. Then say probably TIA but cleared now and sent home again. But I will say one thing if you have not had a stroke before be aware this can be a build up. My husband had a mini stroke every Wednesday leading up to his major one. Also my hubby's stroke was a rare form only 1% of stroke victims have this type, his veins in the brain become weak due to protein build up. So we're not able to operate to stop the bleed or remove any blockage.

But everyone is different. And everyone's body reacts differently so it's hard to predict what will happen in the future. My hubby's blood pressure when he had the stroke was 145/70 so wasn't massively high for a normal individual. But for him it was way too high and caused the bleed.

Best wishes

Shabana

[DonnaA in reply to Shabana1974]

Hi Shabana and thanks for the reply and for sharing your story.

My daughter who is a paramedic, said exact same. That the MRI would probably show nothing. Because I only had one symptom, not being able to lock my door, whatever it was must have went as soon as it came or I’d have had other symptoms alongside it, so of course MRI would show no damage. It was 6 weeks after it happened, that I had the MRI, but a CT scan same night showed nothing sinister either.

When the paramedics first took my blood pressure, it was 160/101, but I was really panicking when they arrived. I’d mentioned my blood pressure at the hospital, but they said although it was a bit high it wasn’t high enough to have had a stroke or TIA happen. So god knows.

My blood pressure is ok at home though, often lower than 120, so they’ve not given me any blood pressure medication.

Hope your husband is all sorted now and he’s well again.

[RegularWalker]

Doctors like to have their elderly patients on statins and aspirin as a precaution. Aspirin 75mg dispersible is a mild blood thinner while Clopidogrel is a strong blood thinner that I had to take for a year after having stents inserted in my heart. I cut my hand while on Clopidogrel and it bled for 2 hours so I can't believe your GP thinks that aspirin and Clopidogrel are alternatives. They are very different. I've taken 75mg aspirin for 7 years with no noticeable effect.

I was also prescribed 80mg Atorvastatin after my HA. My cholesterol was 6.8 and they said it should be less than 4. After a year or two, my cholesterol had plummeted to 2 point something so I halved the dose by taking one every other day. Another annual check with the nurse and it was still good so she changed my scrip to 40mg. Another annual check showed it was still good so I halved it again. I'm now prescribed 20mg Atorvastatin and happy with that.

I also had a suspected TIA since my HA but tests showed nothing and I haven't had any medication for it.

Your weight loss is unexplained so it's difficult to advise but I suggest you take the medication prescribed until you have sufficient evidence to reduce or stop it. It doesn't have to be "for life".

[DonnaA in reply to RegularWalker]

Hi and thanks for reply and sharing,

Elderly? I’m 58, is that elderly? I think I’m pretty young to have something like this happen, or maybe I’m not.

Yes, my GP said there wasn’t much difference between Clopidogrel and Aspirin and if I preferred to stay on Aspirin it was my choice. So I’m sticking to the Aspirin for now. This is why it’s good to read the experiences of others and get feedback, because the professionals don’t always get it right, or some of them don’t know what they are talking about. Reading some of the feedback I’m starting to think my doctors are useless.

In my understand a normal cholesterol reading is 5 or under, so 2 or 3 point something readings seems a bit low. I can’t understand why they’ve given me 40mg of Atorvastatin and especially given my cholesterol is normal, but it’s something I will be asking tomorrow. Maybe he’d recommended 40mg based on my cholesterol reading in 2022 of 5.4 with raised bad cholesterol…..however and after a cholesterol blood test two weeks ago, it’s fine now at 5.1 and no raised bad cholesterol. Therefore they should reduce the dose to 20mg of Atorvastatin perhaps. I am able to control my cholesterol through diet and proved I can.

And the weight loss, I’ve lost one and a half stone since the TIA through diet and really cutting down on what I eat. I’d have further worries if it was unexplained. Still another 3 stone to go though.

All the best and take care!