Premier - Local Cardiologist

  • Stroke of the Heart

    A stroke is indeed a medical emergency that occurs when the blood supply to a part of the brain is disrupted. The interruption of blood flow can happen due to a blockage in an artery (ischemic stroke) or bleeding from a ruptured blood vessel (hemorrhagic stroke).

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    <p><a href="">Cardiologist</a> talks about how the risk of stroke is determined for Atrial Fibrillation patients using the CHADS score.</p>

    Cardiologist talks about how the risk of stroke is determined for Atrial Fibrillation patients using the CHADS score.

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    <p><a href="">Nurse</a><a href=""> Practitioner,</a> discusses how patients diagnosed with atrial fibrillation can take control of their condition through healthy living, diet and exercise</p>

    Nurse Practitioner, discusses how patients diagnosed with atrial fibrillation can take control of their condition through healthy living, diet and exercise

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    <p><a href="">Registered Dietitian</a>, talks about being mindful when it comes to our mental health and the link to bad eating habits.</p>

    Registered Dietitian, talks about being mindful when it comes to our mental health and the link to bad eating habits.

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    <p><a href="">Nurse Practitioner</a><a href="">,</a> discusses how patients diagnosed with atrial fibrillation can take control of their condition through healthy living, diet and exercise</p>

    Nurse Practitioner, discusses how patients diagnosed with atrial fibrillation can take control of their condition through healthy living, diet and exercise

  • Hemorrhagic stroke

    1. Hemorrhagic Stroke: This type of stroke occurs when a blood vessel in the brain ruptures or leaks, leading to bleeding into the surrounding brain tissue. The bleeding disrupts normal blood flow and damages brain cells. High blood pressure (hypertension) is a significant risk factor for hemorrhagic strokes because it can weaken the blood vessel walls over time, making them more prone to rupture.

    2. Transient Ischemic Attack (TIA): A TIA is often referred to as a "mini-stroke" or a "warning stroke" because it produces stroke-like symptoms but resolves within a short period, usually less than an hour. TIAs occur when there is a temporary blockage or reduction in blood flow to a part of the brain. They serve as warning signs that an individual may be at risk of experiencing a more severe ischemic stroke in the future.

    3. Ischemic Stroke: This type of stroke is caused by a blockage or clot that obstructs a blood vessel supplying blood to the brain. The blockage is typically due to the formation of a clot within an artery or the migration of a clot from another part of the body, such as the heart. Ischemic strokes are the most common type, accounting for around 85% of all strokes. Plaque buildup within the arteries, known as atherosclerosis, is a common underlying cause of ischemic strokes.

    It's important to note that both hemorrhagic and ischemic strokes can have severe consequences, and prompt medical attention is necessary in either case. If you or someone you know experiences stroke symptoms, such as sudden weakness or numbness, difficulty speaking, severe headache, or vision problems, it is crucial to seek immediate medical assistance.

  • Preventing Stroke With Anticoagulants in AF Patients

    Atrial fibrillation (AF) is a significant risk factor for strokes. AF is a heart condition characterized by irregular and often rapid heartbeats, which can lead to the formation of blood clots in the atria (the upper chambers of the heart). If a blood clot forms in the atria, it can travel to the brain and cause a stroke.

    The statistic you mentioned, that about one in every five strokes in North America is caused by atrial fibrillation, highlights the significant impact of AF on stroke incidence. In individuals with AF, the risk of stroke is approximately six times higher compared to those without AF. This increased risk is primarily due to the potential for blood clots to form in the atria and subsequently embolize to the brain.

    To mitigate the risk of stroke in patients with atrial fibrillation, healthcare providers often prescribe anticoagulant medications. These medications help prevent blood clot formation and reduce the likelihood of stroke. Different anticoagulants, such as warfarin or direct oral anticoagulants (DOACs), may be prescribed depending on various factors including patient characteristics, medical history, and risk assessment.

    It's important for individuals with atrial fibrillation to work closely with their healthcare providers to manage their condition effectively and reduce the risk of stroke. Regular medical check-ups, adherence to prescribed medications, and lifestyle modifications can also play a crucial role in minimizing the chances of stroke associated with atrial fibrillation.


    Strokes in patients with atrial fibrillation are often caused by blood clots that form in the heart and then travel to the brain, blocking the blood flow and leading to brain cell damage or death. This can result in permanent disability, such as paralysis or difficulty with speech or walking.

    Anticoagulants, commonly referred to as blood thinners, are medications used to prevent the formation of blood clots. While they are often called blood thinners, they do not actually thin the blood. Instead, they work by interfering with the blood's ability to clot, thus reducing the risk of clot formation.

    It is important to note that even when taking anticoagulants, the blood still has the ability to clot. However, these medications significantly decrease the likelihood of clot formation in the heart, which can ultimately reduce the risk of clots traveling to the brain or other organs.

    Warfarin, which has been used for several decades, is one of the traditional anticoagulants. While it has proven to be effective in preventing clots and reducing the risk of stroke, it requires regular monitoring of blood levels and dose adjustments. Warfarin earned the nickname "rat poison" because it was initially used as a rodenticide before its medical applications were discovered.

    In recent years, newer oral anticoagulants have been developed, such as direct oral anticoagulants (DOACs), which include medications like dabigatran, rivaroxaban, apixaban, and edoxaban. These medications offer certain advantages over warfarin, including more predictable dosing, fewer dietary restrictions, and less frequent monitoring. However, the choice of anticoagulant medication depends on various factors, including the patient's medical history, individual risk factors, and shared decision making between the patient and the doctor.

    It's important for patients with atrial fibrillation to work closely with their healthcare providers to determine the most appropriate anticoagulant therapy based on their specific situation and needs.

    Unfortunately, Warfarin is a complicated drug to take, and there are now – in North America and worldwide – at least three and soon four other newer blood thinners, so-called novel oral anticoagulants, are taken once or twice a day, and do not need monitoring.

    In other words, one size fits all, so to speak, and the doctor makes a decision as to what the right dose is for that particular patient, and the patient then takes the medication and is followed up by their doctor. Usually every six months or as infrequently as every year.

    It’s very important that patients have a detailed discussion with their doctors and their pharmacists to make sure that they’re taking their medications appropriately. It’s important to know that medications only work if you take them regularly, exactly as instructed.

    Missing doses or stopping the medication – even temporarily – can put patients at risk for stroke. This is a conversation that is very important to have with your family doctor, with your cardiologist if you have a cardiologist, and your pharmacist to make sure that you’re taking the medications exactly as recommended in the right time frame, and that you don’t miss any doses. This is an ongoing challenge for patients and for doctors, to make sure that the medicines are taken exactly as they’re supposed to be taken.   Often seeing a local family physician or a pharmacist in conjunction with a registered dietitian is a great option to take control of dehydration. In conjunction with healthy eating, exercise and  Smart Food Now


  • Atrial Fibrillation and Your Risk of Stroke


    Proper medication adherence is crucial for individuals with atrial fibrillation who are prescribed anticoagulants. These medications play a vital role in reducing the risk of stroke by preventing blood clots from forming in the heart. Here are some key points to consider regarding anticoagulant therapy and medication adherence:

    1. Importance of adherence: Consistent and regular intake of anticoagulant medications is essential to maintain their effectiveness in preventing blood clots. Missing doses or discontinuing treatment can significantly increase the risk of stroke.

    2. Shared decision making: Patients and doctors should engage in shared decision making when choosing the most suitable anticoagulant. Factors such as patient preference, lifestyle, potential side effects, and adherence considerations should be discussed to ensure the chosen medication aligns with the patient's needs.

    3. Warfarin monitoring: If a patient is prescribed warfarin, regular monitoring of their international normalized ratio (INR) is necessary. INR measures the blood's clotting ability and helps adjust the warfarin dosage to maintain its effectiveness and avoid complications. Close communication with healthcare providers is important to manage warfarin therapy appropriately.

    4. Novel oral anticoagulants (NOACs): NOACs, such as dabigatran, rivaroxaban, apixaban, and edoxaban, are newer alternatives to warfarin. These medications have a more predictable effect and do not require routine monitoring of INR. However, they still need to be taken consistently and as prescribed.

    5. Patient education: Healthcare providers should educate patients about the importance of medication adherence and the potential consequences of non-adherence. Clear instructions on when and how to take the medication, possible side effects, and what to do in case of missed doses should be provided.

    6. Support systems: Patients may benefit from utilizing support systems to improve medication adherence. This can include setting reminders, using pill organizers, involving family members in medication management, or utilizing mobile applications designed to track medication schedules.

    7. Open communication: Patients should maintain open communication with their healthcare providers regarding any concerns, side effects, or difficulties they experience with their medication regimen. This allows for timely adjustments or alternative solutions to be considered.

    Remember, the ultimate goal of anticoagulant therapy in atrial fibrillation is to prevent strokes and their potential life-altering consequences. Adhering to prescribed medications and working closely with healthcare providers will significantly contribute to achieving this goal and ensuring better long-term outcomes.

    When a stroke occurs, brain cells are deprived of oxygen and nutrients, leading to their rapid death. This can have various effects on the individual, depending on factors such as the type of stroke, the location of the brain damage, and the extent of the damage.

    The symptoms and effects of a stroke can vary widely but often include sudden weakness or numbness on one side of the body, difficulty speaking or understanding speech, severe headache, dizziness, loss of balance or coordination, and vision problems. These symptoms typically appear suddenly and require immediate medical attention.

    Prompt treatment is crucial in order to minimize brain damage and prevent further complications. In the case of an ischemic stroke, treatments such as administering clot-dissolving medication (thrombolytics) or performing a procedure to remove the clot (mechanical thrombectomy) can be effective within a specific time window. For a hemorrhagic stroke, controlling bleeding, reducing pressure on the brain, and addressing the underlying cause are important.

    Following a stroke, rehabilitation is often necessary to aid recovery and regain lost functions. This may involve physical therapy, occupational therapy, speech therapy, and other interventions tailored to the individual's needs. Stroke survivors may experience a wide range of long-term effects, which can include physical disabilities, cognitive impairments, emotional changes, and speech difficulties.

    Taking steps to prevent a stroke is crucial for maintaining brain health. This can involve managing risk factors such as high blood pressure, high cholesterol, diabetes, obesity, and smoking. Adopting a healthy lifestyle that includes regular exercise, a balanced diet, and avoiding excessive alcohol consumption can also help reduce the risk of stroke. Regular medical check-ups and adhering to any prescribed medications can further contribute to stroke prevention.



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