Aha stroke prevention guidelines
Common Questions and Answers about Aha stroke prevention guidelines
stroke
Primary prevention is a lot less effective than secondary prevention (as judged by the number needed to treat to prevent one stroke per year).Recent guidelines detail the evidence for primary prevention in stroke. Because stroke may indicate underlying atherosclerosis, it is important to determine the patient's risk for other cardiovascular diseases such as coronary heart disease. Conversely, aspirin prevents against first stroke in patients who have suffered a myocardial infarction.
Having two episodes of only seconds in length does not warrant Coumadin, per the 2006 AHA guidelines, with link included below. At your young age, and with relatively few risk factors, and with your episodes so infrequent and short, I would refuse Coumadin at this time. Of course your ASA is quite appropriate and should be continued. My EP and Dr.
But in June, the NHLBI decided to hand over the responsibility of developing guidelines to the American College of Cardiology (ACC) and the American Heart Association (AHA). That process eventually led to the release of guidance for the prevention of atherosclerotic cardiovascular disease last month.
Whereas the ADA used to recommend low-dose aspirin for every diabetic patient over the age of 40, their new guidelines suggest aspirin as a prevention strategy only in those with diabetes whose cardiovascular risk is above average. This includes men over age 50 or women over age 60 with at least one additional major risk factor. In other words, according to the ADA, younger diabetic patients without associated cardiovascular risk factors appear not to benefit from taking aspirin.
If you are going for heart cath, be prepared to accept a stent included with the test (more money). AHA/AAC guidelines recommend a stent implant if the occlusion is greater than 70%. There are cardiologists that stent occlusions less than 70%!!
Family history is considered a risk, but to go for a cath based on that risk only is usually not a consideration and doesn't follow the AHA/AAC guidelines. If you have angina with exertion, does medication provide relief?
Hypertension guidelines are constantly evolving. The 2017 ACC/AHA guidelines recommended a more aggressive goal of below 130/80 for all. For more info: http://www.onlinejacc.org/guidelines/highbloodpressure.
Lesions less than 70% occlusion do not require intervention according to the guidelines of the AAC/AHA unless there are associated symptoms uncontrolled with medication
It is generally accepted proper therapy for stent implant patients to be on a regimen of plavix and aspirin for about a year as it appears drug eluding stents have tendancy to form clots. The ACC and AHA guidelines recommend not to be on plavix any longer than necessary as the risk out weighs any benefit. Aspirin indefinitely.
There may be exceptions, but I am not aware of any.
cholesterol, increases your risk of heart attacks and stroke. The American Heart Association (AHA), the American College of Cardiology (ACC) and the National Institutes of Health (NIH) define "very high" LDL cholesterol as above 190 mg/dL, "high" as 160 to 189 mg/dL, "borderline high" as 130 to 159 mg/dL, "above optimal" LDL cholesterol as 100 to 129 mg/dL and "optimal" as less than 100 mg/dL.
The RCA blockage meets the ACC and AHA guidelines for angioplasty and the blockage is severe enough to cause angina with exertion and no angina when relaxed does indicate ischemia (lack of blood flow to the heart cells). Follow your doctor's recommendation.
http://www.medhelp.
This helps reduce the workload of the heart and also reduces your risk of stroke. The doses of both these medicines for you is very small, if you get good control off these medicines as it is then removing them is a bad idea.
Blood pressure has a rebound effect. So removong the lower dose of meds could put you in a situation where a higher dose is required in the future.
In short all of your meds are lifesaving. I would not advise pulling them.
Your angiogram does not indicate any serious problems associated with an MI as indicated by the 55% LVEF. The general consenus of the medical community the AHA/AAC provides guidelines to not intervene with any occlusions that are not greater than 70%. If the occlusions are greater than 70%, treat with medication, and if medication does not provide any relief to symptoms (usually angina...chest pain) then stent the appropriate occlusion.
Arthur Agatston
taking daily aspirin to prevent heart attack and stroke. Recent research has shed new light on this. Indeed, mounting evidence reported in a number of leading medical journals now suggests that if you’re healthy and not at significant risk for a heart attack, you should not be taking aspirin preventively. That’s because the studies show that aspirin doesn’t reduce the risk of dying from a heart attack or stroke in healthy people.
The second doctor's opinion follows the correct protocol according to AAC/AHA guidelines. Generally, blockage less than 70% is not considered serious enough for a stent unless there is pain associated with the blockage and not controlled with medication and then a stent before a bypass (surgery).
There is absolutely nothing stated in your post that warrants cracking open your father's chest cavity and performing a risky operation.
If your mother has symptoms i.e. chest pain and there is relief with medicaion, then medication should be the option of choice according to ACC/AHA guidelines. Lesions less than 70% usually don't require any treatment.
The next option would be stent implants. If stents cannot be considered because of location, size, or an emergency, then a bypass.
I have a totally blocked LAD and 72% Lcx blockage, and I have been on a regimen of medication, diet, exercise, etc. without any problems.
Of course there is a difference in preparation and lowering your risks to help prevent stroke or heart attack. Prevention is always the best approach, as much as possible that is.
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