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Lee Kirksey, MD  
Male
Cleveland , OH

Specialties: Peripheral Arterial Disease, PAD

Interests: vascular, specialist, treatment options
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Stroke Symptoms-Do You Have Them

Apr 29, 2008 - 19 comments
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Stroke

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hypertension



Stroke Risk Factors

Some stroke risk factors are hereditary.  Others are a function of natural processes.  Still others result from a person's lifestyle.  You can't change factors related to heredity or natural processes, but those resulting from lifestyle or environment can be modified with the help of a healthcare professional. Fortunately, most risk factors are under our control

What risk factors for stroke can't be changed?

Age - The chance of having a stroke more than doubles for each decade of life after age 55.  While stroke is common among the elderly, a lot of people under 65 also have strokes.

Heredity (family history) and race - Your stroke risk is greater if a parent, grandparent, sister or brother has had a stroke.  African Americans have a much higher risk of death from a stroke than Caucasians do.  This is partly because blacks have higher risks of high blood pressure, diabetes and obesity.

Sex (gender) - Stroke is more common in men than in women.  In most age groups, more men than women will have a stroke in a given year.  However, more than half of total stroke deaths occur in women.  At all ages, more women than men die of stroke.  Use of birth control pills and pregnancy pose special stroke risks for women.

Prior stroke, TIA or heart attack - The risk of stroke for someone who has already had one is many times that of a person who has not.  Transient ischemic attacks (TIAs) are "warning strokes" that produce stroke-like symptoms but no lasting damage. TIAs are strong predictors of stroke.  A person who's had one or more TIAs is almost 10 times more likely to have a stroke than someone of the same age and sex who hasn't.  Recognizing and treating TIAs can reduce your risk of a major stroke. If you've had a heart attack, you're at higher risk of having a stroke, too.  

What stroke risk factors can be changed, treated or controlled?

High blood pressure - High blood pressure is the most important controllable risk factor for stroke.  Many people believe the effective treatment of high blood pressure is a key reason for the accelerated decline in the death rates for stroke.

Cigarette smoking - In recent years, studies have shown cigarette smoking to be an important risk factor for stroke.  The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system in many ways.  The use of oral contraceptives combined with cigarette smoking greatly increases stroke risk.

Diabetes mellitus - Diabetes is an independent risk factor for stroke.  Many people with diabetes also have high blood pressure, high blood cholesterol and are overweight.  This increases their risk even more.  While diabetes is treatable, the presence of the disease still increases your risk of stroke.

Carotid or other artery disease - The carotid arteries in your neck supply blood to your brain.  A carotid artery narrowed by fatty deposits from atherosclerosis (plaque buildups in artery walls) may become blocked by a blood clot.  Carotid artery disease is also called carotid artery stenosis.   Peripheral artery disease is the narrowing of blood vessels carrying blood to leg and arm muscles. It's caused by fatty buildups of plaque in artery walls.  People with peripheral artery disease have a higher risk of carotid artery disease, which raises their risk of stroke.

Atrial fibrillation - This heart rhythm disorder raises the risk for stroke.  The heart's upper chambers quiver instead of beating effectively, which can let the blood pool and clot.  If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results.

Other heart disease - People with coronary heart disease or heart failure have a higher risk of stroke than those with hearts that work normally.  Dilated cardiomyopathy (an enlarged heart), heart valve disease and some types of congenital heart defects also raise the risk of stroke.

Sickle cell disease (also called sickle cell anemia) - This is a genetic disorder that mainly affects African-American and Hispanic children.  "Sickled" red blood cells are less able to carry oxygen to the body's tissues and organs.  They also tend to stick to blood vessel walls, which can block arteries to the brain and cause a stroke.
High blood cholesterol - People with high blood cholesterol have an increased risk for stroke.  Also, it appears that low HDL (“good”) cholesterol  is a risk factor for stroke in men, but more data are needed to verify its effect in women.

Poor diet - Diets high in saturated fat, trans fat and cholesterol can raise blood cholesterol levels.   Diets high in sodium (salt) can contribute to increased blood pressure.  Diets with excess calories can contribute to obesity.  Also, a diet containing five or more servings of fruits and vegetables per day may reduce the risk of stroke.

Physical inactivity and obesity - Being inactive, obese or both can increase your risk of high blood pressure, high blood cholesterol, diabetes, heart disease and stroke.  So go on a brisk walk, take the stairs, and do whatever you can to make your life more active.  Try to get a total of at least 30 minutes of activity on most or all days.
What are other, less well-documented risk factors?

Geographic location - Strokes are more common in the southeastern United States than in other areas.  These are the so-called "stroke belt" states.

Socioeconomic factors - There's some evidence that strokes are more common among low-income people than among more affluent people.

Alcohol abuse - Alcohol abuse can lead to multiple medical complications, including stroke.  For those who consume alcohol, a recommendation of no more than two drinks per day for men and no more than one drink per day for nonpregnant women best reflects the state of the science for alcohol and stroke risk.
Drug abuse - Drug addiction is often a chronic relapsing disorder associated with a number of societal and health-related problems.  Drugs of abuse, including cocaine, amphetamines and heroin, have been associated with an increased risk of stroke.

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by momtofourboys, Apr 29, 2008
so far I am not at risk. however what type of congential heart defects are you talking about and if you had them corrected as a child, are you still at risk?

Michelle

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by sickman15, May 20, 2008
How can I controll my cholestral and high blood presure without the meds. Ive taking three different bp meds and they all make me feel ill. Bad muscle pain. I am a 37 yearold black male.

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by Lee Kirksey, MDBlank, May 20, 2008
Sickman15
Good question. It's not easy, but well worth the effort. Im sure each of the meds youre on currently, are necessary to control your blood pressure but they have side affects. The key to improving your blood pressue and cholesterol is improving your diet and exercise program. A diet low in saturated fat, cholesterol and salt is important. Work with your doctor to do these things so that if they can't get you off the meds, they can at least decrease the dosage which many times can improve your side affect symptoms. It depends on how motivated your are to Live. Good Luck

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by Me967, Jun 17, 2008
Hello Dr. Kirksey.

I think I'm at risk; but, not sure.  

I do have issues with:   Heredity (family history), Prior stroke, TIA or heart attack,  Cigarette smoking, obesity (work out daily; but, have hypothyroid issues- 5.5 at 170#), types of congenital heart defects (interatrial septal aneurysm).  

As "momtofourboys" asked I'm not sure if an ASA counts, or are you talking about a defect that has to be fixed.  I don't think (?) a ASA ever has to be though.  I don't know.  I've been really hoping to see an answer to clarify this.  

I was also really wondering why your heart rate would go from a Resting HR of 52 one week to 101 the next week?  It seems crazy to me.  When cutting grass or tilling the garden it will shoot up to 146-165.

I take Lopressor and Lipitor along with diazide/maxide and (low dose aspirin for defect) as far as heart meds.  

Can low thyroid, iron, and sugar cause this HR change?  I also get chest pains often and I'm very aware of my heartbeat in which I would rather not feel.  Sometimes I don't feel it for weeks though too which is great!   ???

I had a stress test and echo that came out pretty good.  My EF dropped from 72% (two years ago) to 53%; this year, but I think that's alright?  

I would greatly appreciate your input on this.  Thank you so very much for being on here for us.  

Take Care;  Amy



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by Me967, Jun 17, 2008
Hi. I finally got up the nerve again to ask and I'm sorry.   I just realized I posted to an old thread.  Just my luck.  LOL

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by bobjan, Jul 06, 2008
I have been on medication for the past few months for HBP. Two months ago my reading was 120/80, but now its up again to 140/90. I am also experiencing , what can be described as ' short circuiting' in my head; otherwise I feel fine. I know I am overweight and need to exercise more, but the ' short-circuiting' has me really worried. I will be seeing a doctor tomorrow. Any advice.

bobjan. Sunday 6/07/2008

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by chewie4, Jul 25, 2008
Hi my dad suffered a massive stroke in March, loosing his movement in his left side.  Today he took what I believe was a TIA ( his right side of face was droopy, and he had severe numbness on his right side all of which came back in a half an hour) before this happened he also complained of a headache.  His Dr said this is common.  I am very concerned, is it common or should he be sent to have scan done to see if there is a blockage ?

Thank you.

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by brandam, Jul 30, 2008
I am also at high risk for heart disease, I'm a smoker and am overweight and do not work out because of a physical injury to my spine.  I was just wondering what you would recommend as I suffer from symptoms such as a heavyness in my chest, almost feels like anxiety, can actually feel the pressure from my own heartbeat, can feel sick to my stomach, weak and shakyness almost like Im having anxiety, and under my left breast high up it aches and feels uncomfortable sometimes, do u think this is something I should worry about?, I also am 41 and have suffered from High Blood Pressure since I was 18, and have been on medication ever since., I'm just scared I could have  a stroke or heartattack and not even be aware of it....Thank You.....brandam

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by angelineteh, Oct 26, 2008
My dad felt numbness and pain on his right leg today for the first time. It is so pain that he can't even stand for more than 20 seconds. But he won't feel the pain so much while sitting or squatting. Is this a sign of stroke?

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by GarnetteGrasty, Nov 21, 2008
I am in the military and sometimes our care is not the best.  We get the run around.  For about two years, I've had this strange pain in the top of my head on and off.  Sometimes this pain is accompanied by a feeling of numbness on the left side of my face and in my left arm.   This pain goes and comes.  While I was deployed to Kuwait, I don't remember having it.  But I have it right now as I type.  I went to the hospital on post today and was given some numbers to call.  They won't see you unless it is an emergency.  I'm going to the emergency room after I type this.  On my way to work, I remembered my mother complaining about a pain right in the top of her head.  She had a stroke and then died of congestive heart failure (sp) in 2003.  Every one of my aunts died of a stroke.  One uncle had an aneurism. None of my sisters or brothers had/have these issues.  The pain in my head is not dead center like my mother complained of, but the top left.  Again, it goes and comes.  I need to know what this might be and what terms do I use to get the military doctors to perform the correct tests because they will do the least amount of tests humanly possible and I will be dead in the waiting room.  I'm really not kidding.  

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by albertwilkes, Nov 24, 2008
Im 18 bout to be 19. I finally realized that i have high blood pressure while doing sports at school. I was getting bad headaches behind my right eye and sometimes my left. I had my blood pressure taken and its always 160 - 180 over 90-120. i been to a specialist and after bout a year finally realized dat its genetic and all i could do is take meds. i was doin ok. but i turned 18 and had no insurance so i now hav no meds and its been a whilew now and soo far nothing bad happening but them bad headaches once a week or once every 2 weeks. do you think i have a big risk of getting a stroke??? no one in my family had one or anything and my dad mom and there parents have high blood pressure to this day. thanks.

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by minnie0903, Dec 31, 2008
Hello DR...
I really need you help! I dont know if all these symptoms that im having is due to me having a stroke...
I am 24 years old. I had a kid about a year ago and ever since i gave birth there has been alot of changes in my body...But i get these really strange headaches...like behind my right ear and my left arm too...whats wierd is that it comes and goes randomly...Im very scared because i dont want to think its a stoke or something related to my heart... please help me!

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by krstin, Dec 31, 2008
hi doc , my local doctors have given up on me where they insist i go and see a doc 2hours away at a teaching hospital, my family doc things its amazing every month i walk into his office each month because im still alive. my blood pressure runs about 220/150 and thats on a good day , i am currently on 12 medications to controll it and they dont work, last month i went to the hospital with bp of 250/160 almost gave the nurse a heartattack because she never saw anything like that in here life. hooked me up interveinously stayed the nighted pumped it into my veins and it only came down to 190/150 saw it was going nowhere and sent me home. i get headaches so bad that im pretty sure that if guns were legal in canada i would of finished a long time ago and everyone around me knows that because thats how bad my headaches get please help me in canada

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by deegee23, Apr 14, 2009
Dr. Kirksey,

My mother is a 79 year old who lives in NJ and has dialysis 3 times per week and has a pace maker. In reading your article on PAD, it suddenly made me realize that my Mom has many of the symptoms described. She has complained about leg pain while walking, she now has sores on her legs that heal with scars and more importantly, her feet are very discolored, top and bottom and were painful and swollen. She recently visited her vascular doctor who administered a Doppler test. He said her pressure was good, although not perfect, but more importantly, the lower and upper extremities had the same pressure measurement.

My mother just visited her cardiologist regarding her pacemaker and all seemed to be well there too. I think for me, it is very difficult not knowing what is causing the pain and tightness in her legs, the discoloration on her feet and the sores that heal, but with scarring. In my heart of hearts, I know whatever it wrong, it needs attention now, but no one seems to view what's going on with her as serious. If I could provide you with particular information that might help you suggest the possibilities of what could be out of sorts with my mother, I would be forever greatful. Whatever comes to mind, please ask. I will get the answers if I don't know them off-hand.

Any information you can provide is greatly appreciated.

Thank you.
deegee23

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by charlottelloyd, Aug 04, 2009
Hi
I have a question, first let me explain the background. From 2007 to February 2009 I was running 3 to 5 times per week at the gym, at speeds of 10 to 11km per hour and always with changing inclines. This was great.
I stopped in February when I was diagnosed with Gilberts syndrome and started running again in July and have been obviously running slower at 9.5/9km per hour, a slower workout. Yet sometimes, after 20 minutes  of running I get a pressure pain in my head, as if a thick elastic band is being pulled round it. Then I slow down and walk and it eases off.
Is this an indication of low blood pressure? My blood pressure was taken in June a few times and it was fine. I also had a full bio chem blood test in June and that was normal (apart from billirubin of course) I would like to know what this means, am I just out of shape, have lowe blood pressure, or is it some cardiovascular danger?

Many thanks!

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by Howard1962, Sep 19, 2011
Hello,

I ran a 10k race on Aug 28.  I have run many races and I am in excellent shape.   5'7" and 142 pounds.  No fat.

I pushed myself to the point of exhaustion and felt very light headed and had a hard time breathing.   People thought I looked bad and I did feel bad.   I have never felt this bad after a race.

I felt better but I was still out of it.   Since then I have had a pain in the temple area of my head on the left side.   I also feel tired and off balance.   I am able to think and still coordinated.  

I went to see a physician Aug 31 thinking I had a TIA or worse.   He ran blood tests and showed no real signs of anything.

I have been running a working out and feel fine while I am doing it.   I have had trouble with continuous sleep and I just feel out of sorts.   I have been taking aspirin and Vitamin D.   Any suggestions and do you know how long this should last?

Thank you.

smyers@myers-financial.com

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by imirish69, Sep 26, 2011
Did he do a MRI or just blood work? I would think, he would need to do a CT scan or MRI?
I may be wrong but I was just curious.
I have to go tomorrow for a doppler of my carotid arteries and echocardiogram after what we thought was a probable diagnosis of MS, then a MRI revealed a stroke of some sort. I'm left with what they think is, "Cheiro Oral Syndrome", a drunk feeling, left arm numbness, left tongue & mouth numbness as well.
I hope they find out what happened to you.
Have a good day.

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by chuckspook1, Jun 20, 2012
You covered the risk factors pretty well, but didn't actually talk about the symptoms. Last night I woke up with severe pain in one specific spot on the back of my head. I also thought I was hearing voices, but couldn't understand anything being said. Of course I was the only one awake. I was able to eventually go back to sleep. The only thing I've noticed today has been my left eye has been tearing up all day. Could I have possibly had a "temporary stroke"?

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by sara12345, Jun 20, 2012
You should look at the Stroke Association on-line or just type in stroke symptoms.  Good luck.

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