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Atrial Fibrillation (AFib) and Stroke: How To Recognize and Respond to a Stroke

Posted on June 15, 2022
Article written by
Caroline Wallace, Ph.D.

  • People with atrial fibrillation, or AFib, have an increased risk of stroke.
  • A stroke is a medical emergency. Call emergency services right away if you or someone you’re with experience symptoms of a stroke.
  • Learn the acronym “FAST” to recognize the signs of a stroke.

Atrial fibrillation is the most common type of irregular heartbeat, or cardiac arrhythmia. This medical condition occurs when the heart’s upper chambers (the atria) beat out of sync with the lower chambers (the ventricles). AFib requires proper treatment since people living with the condition have a higher risk of stroke.

Strokes are a medical emergency that requires quick action and treatment to minimize brain damage and disability. Keep reading to learn more about strokes and how to think “FAST” if you or someone you’re with shows signs of a stroke.

What Is a Stroke?

A stroke is a medical emergency that is caused when blood flow to part of the brain is blocked or reduced. Compared with other cells in the body, brain cells are more sensitive to interruptions or changes in blood flow. Uninterrupted blood flow is critical for brain cell survival — the blood brings essential nutrients and oxygen.

There are three types of strokes:

  • Ischemic strokes are the most common type. They occur when plaque (deposits on the artery walls) or a blood clot blocks the flow of blood in a region of the brain.
  • Hemorrhagic strokes are less common. They occur when a blood vessel breaks and leaks blood into the brain.
  • Transient ischemic attack (TIA) is similar to an ischemic stroke, but the blockage is temporary. TIA is often called a “ministroke.”

What Are the Symptoms of a Stroke?

The symptoms of a stroke come on suddenly. Knowing the signs of a stroke can help you take quick actions to possibly save a life — or your own life. Here are the signs and symptoms of a stroke:

  • Headache — A sudden severe headache, which may come with vomiting, dizziness, or altered consciousness
  • Vision problems — Sudden blurred or blackened vision in one or both eyes
  • Trouble speaking or understanding — Confusion, difficulty understanding speech, or slurred words
  • Paralysis or numbness of the face, arm, or leg — Loss of feeling or movement that occurs suddenly, and often affects just one side of the body
  • Trouble walking — Sudden loss of coordination that may cause stumbling

Men and women have similar general stroke symptoms. However, there are some gender differences that make women less likely to think that their symptoms are a medical emergency. Studies have shown that women tend to have more vague symptoms of stroke, including generalized weakness, fatigue, and confusion or disorientation.

If you or someone you’re with experiences any of these symptoms, get immediate medical help by calling for an ambulance. Emergency medical personnel can begin life-saving treatments on the way to the hospital, so do not try to drive to the hospital yourself.

With a stroke, every single minute counts. The stroke treatments that are most effective can only be given within the first three hours after symptoms begin. Do not wait to see if the symptoms go away. Even if the symptoms disappear, it’s important that you get immediate help from a health care provider. The longer a stroke is untreated, the higher the chance for permanent brain damage and disability.

Stroke Risk Factors

Some stroke risk factors can be managed with lifestyle changes and medications. Other stroke risk factors cannot be changed, including older age and your genetic and racial background. Talk with your health care provider if you have concerns about any of the following stroke risk factors:

  • High blood pressure — High blood pressure (140/90 mm Hg or higher) can damage the blood vessels in your brain.
  • Heart disease — This includes coronary artery disease.
  • High cholesterol — This leads to a thickening of the arteries.
  • Diabetes — People with diabetes have a higher risk of stroke.
  • Irregular heart rhythms — Irregular heart rhythms, including atrial fibrillation and atrial flutter, can cause blood to pool and clot.
  • History of TIAs — People with a history of TIAs are nearly 10 times more likely to have a full ischemic stroke than someone who does not have a history of TIAs.
  • Lifestyle choices — Smoking, using illegal drugs, drinking excessive amounts of alcohol, and a lack of exercise increase your risk of stroke.

Why Do People Living With AFib Have a Higher Stroke Risk?

If you or someone you know is living with AFib, then it is important to reduce the risk of stroke. This is because the risk of stroke is four to six times higher in people who have had AFib.

AFib, a very irregular heart rhythm, causes blood to pool within the chambers of the heart. Pooled blood can form clots — masses of blood cells caused by the coagulation of blood. If a blood clot leaves the heart, it can travel to the brain or other parts of the body. There, it can block blood flow and cause an ischemic stroke.

Your health care provider may recommend the following stroke prevention treatment options:

  • Blood thinners, such as warfarin (Coumadin), or direct oral anticoagulants, such as dabigatran (Pradaxa), rivaroxaban (Xarelto), or apixaban (Eliquis)
  • Certain anti-arrhythmic medications used to treat AFib, such as dronedarone (Multaq), may also reduce the risk of stroke
  • Surgical procedures, such as catheter ablation to destroy abnormal electrical pathways in the heart, which can help maintain a normal heart rhythm
  • Lifestyle changes, like eating a heart-healthy diet, gradually increasing physical activity, stopping smoking, and avoiding excessive alcohol consumption

What Should You Do If You Experience Symptoms or See Them in Someone Else?

The American Stroke Association recommends learning and sharing the acronym FAST to help save a life. Each letter represents a different step in the process:

  1. Face — Is one side of the face drooping? Asking the person to smile will help assess this.
  2. Arms — Can the person raise both arms? If one arm drifts down or is unable to rise, the person may be having a stroke.
  3. Speech — Ask the person to repeat a simple phrase and listen for slurred or strange speech.
  4. Time — If you observe any of these signs, immediately call 911 to get emergency medical help.

Make sure you pay attention to the time the symptoms begin, since this information will be helpful to the first responders. Remember that early treatment can help improve quality of life after a stroke.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with atrial fibrillation and their loved ones. More than 48,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Do you have AFib? Have you spoken with your doctor about stroke risk? Share your experience in the comments below, or start a conversation by posting on MyHeartDiseaseTeam.

All updates must be accompanied by text or a picture.
Larry A. Weinrauch, MD, FACC, FACP, FAHA is an assistant professor of medicine at Harvard Medical School with a focus on cardiovascular disease and clinical outcomes research. Review provided by VeriMed Healthcare Network. Learn more about him here.
Caroline Wallace, Ph.D. has a doctorate in biomedical science from the Medical University of South Carolina. Learn more about her here.

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