Luke Perry Stroke

Luke Perry Stroke

PATIENT EDUCATION

Stroke is no longer
an “old age” risk

Adults as young as
40 are now at risk.

Here’s what you need
to ask your doctor.

Luke Perry’s death, just four days after FOX announced that it would be re-booting “Beverly Hills, 90210”, the TV show that made him 90’s icon, came as a surprise to fans who were hoping he would return as “Dylan McKay.” This role cemented Perry’s iconic image as the standard of cool for the generation who grew up after Jim Stark, the troublemaking teen played by James Dean in the epic 1955 film “Rebel Without A Cause.” The two characters not only shared similar backstories, dangerous loners who lived on the edge; the actors also shared a striking similarity in appearance.

The news report that The Los Angeles Fire Department responded to a “medical assistance” call at Perry’s home on Wednesday, February 27, dominated the headlines. At first, officials say Perry was talking to first responders and was fully conscious. This was just days after TV announcement; fans were shocked to learn that the star, at 52 years old was hospitalized due to a massive stroke. We were all saddened when the news broke the following Monday of his passing.

Redefining stroke

Stroke, as with many other forms of heart disease, is often thought of as an “old person’s” health concern. While there are more than 200,000 stroke cases in the US every year, making it the fifth leading cause of death in our country, the primary age affected is 60 years old and up. However, recent health trends have shown a growth in diagnosis with adults aged 41-60. “People can have strokes at any age,” says Maryellen King, Nurse Practitioner at Capital Cardiology Associates. Ultimately, if you have a concern about your risk of stroke, heart attack, or heart disease make an appointment with your doctor or primary care provider, today.

The traditional factors that put you at risk for stroke are lifestyle, diet, physical activity – which are controllable — tobacco use and smoking double the risk of stroke when compared to a nonsmoker. Smoking increases clot formation, thickens the blood, and increases the amount of plaque buildup in the arteries. Abusing alcohol and drugs (cocaine, amphetamines, and heroin) have been associated with an increased risk of stroke. The uncontrollable risk factors are your family history, age, race, gender, and prior heart health history.

There are also uncommon causes of stroke which are usually congenital (birth disorders) or rare vascular blood vessel diseases.

The recommendations for adults in their 40’s who are concerned about lowering their risk of stroke, heart attack or heart disease are:

• Eat a healthy diet, including reducing salt intake.
• Engage in regular physical activity and maintain a healthy weight.
• Manage stress.
• Avoid tobacco smoke.
• Take your medication as prescribed.
• Limit your alcohol consumption.

What is a stroke?

The National Stroke Association defines a stroke as “a brain attack.” Essentially, you have an instance where you’re losing blood flow to a part of the brain. “There are different types of stroke, hemorrhagic (bleeding in the brain), embolic (a blood clot that travels),” says King. Hemorrhagic strokes are less common; only 15 percent of all strokes are hemorrhagic, but they are responsible for about 40 percent of all stroke deaths. They can occur as a cerebral aneurysm, a congenital malformation of the arteries in the brain that can rupture. “There is no way to know if you have an aneurysm or not. If it ruptures, you can have bleeding on the brain, and people can die from that. They would experience sudden severe headache, the bleeding in the brain, patients will say the worst headache of their life. It’s not a warning sign, that’s a symptom,” stated King.

The other form of stroke is called an ischemic stroke. This can happen when a sticky, fatty material called “plaque” builds up in a blood vessel in your brain. Plaque slows your blood flow. It may cause your blood to clot. This can stop the flow of blood completely. This kind of stroke can also happen when a clot travels to your brain from another part of your body, even if you don’t have plaque buildup in your vessels. The most common cause of this type of stroke is A-Fib (atrial fibrillation) when your heart has an abnormal rhythm that produces the opportunity for a clot to form in the left side of the heart, dislodge and travels up and through to the brain.

A patent foramen ovale (above) is a hole in the heart that didn’t close the way it should after birth. The condition affects about 25% of Americans, but many do not know it.

The other type of embolic stroke would be a patent foramen ovale (PFO) or some different kind of congenital hole in the right and left sides of the heart. “The sides of your heart are supposed to be separate; blood comes from the right side of the heart is pushed to the lungs. It comes to the left side of the heart and gets pushed through the body. When there is a hole between the two sides, clots form and can travel from one side to the other,” said King. Most patients with a PFO do not have any symptoms. However, the condition may play a role in migraine headaches and it increases the risk of stroke, transient ischemic attack and heart attack.

Advances in testing

For patients who present stroke symptoms (Numbness or weakness in your face, arm, or leg, especially on one side. Confusion or trouble understanding other people. Difficulty speaking. Trouble seeing with one or both eyes. Problems walking, staying balanced, or loss of coordination. Dizziness. Severe headaches that come for no reason.) there are testing procedures. “The only way to find the holes in the heart would be with an echocardiogram, an ultrasound of the heart, to evaluate to see if a PFO has formed,” said King. Echo tests are performed by specially trained technicians at Capital Cardiology Associates. The test is painless, has no side effects, and usually takes an hour. “Using an echocardiogram (ECG) we can inject ‘fizz’ essentially, a trace amount of agitated saline that we call a ‘Bubble Study.’ These tiny bubbles can be seen on an ECG moving across the septum,” King explained. An ECG allows a physician to view the heart’s structure and check how the heart functions.

The other test available is the Transcranial Doppler (TCD), a non-invasive ultrasound method used to examine the blood circulation within the brain. A specially trained technician at Capital Cardiology Associates Imaging Suite performs this test to determine the amount of blood flow to specific areas of your brain. “The main reason that we started doing this is to detect a shunt or a hole in the heart,” shared Dr. Jeffrey Uzzilia of Capital Cardiology. “Patients that had a stroke, one of the reasons why they had a stroke that is not obvious at the time, is they can have a hole in their heart where a blood clot can form somewhere in the body and cross through that hole from the right side of the heart to the left. Once that blood clot is on the left side of the body it can travel anywhere in the body, including the brain and cause a stroke. Something like a PFO that everyone is born with, for most people it will close, for about 25% of people it will stay open. The TDP is the most accurate, sensitive test to detect that. It’s a very easy thing to see. There’s a good portion of patients, like Luke Perry, that you are shocked as to how young they are when they have a massive stroke,” said Dr. Uzzilia.

Written by: Michael Arce, Marketing Coordinator, Capital Cardiology Associates Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.

National Wear Red Day

National Wear Red Day

HEART MONTH

Wear Red for Women, Everyday

Heart disease is the number one killer of women and you can take steps to prevent it

National Wear Red Day is the first Friday in February when women are encouraged to wear red to raise awareness about heart disease, the number one killer of women. “This is something that is personally dear to my heart,” stated Dr. Heather Stahura. She recently joined Capital Cardiology Associates in the summer of 2018 and is on a mission to educate women on their risk of heart disease, including the steps they can take to prevent becoming a statistic. “It’s fascinating, I will talk to women and ask them what health issue they think is their biggest worry. Unanimously women will tell me breast cancer. Statistically, breast cancer will affect 1 out of 8 women but most women will do well, thanks to the research and advancements in treatment over the past few years. The staggering fact is 1 out of every three women will die of a cardiovascular disease issue over the span of their lives. That’s our sisters, our mothers, our daughters, our friends. I think that is what the Go Red for Women (movement) is about informing us of our risk, starting that conversation with our doctor, and making the change to live our healthiest life.”

Heart disease includes more than a risk of heart attack or stroke

Part of educating women on their risk of heart disease requires breaking old stereotypes. “People constantly think of heart disease as being an older person issue, and it’s not,” said Dr. Stahura. A survey of more than 4,000 healthy individuals with an average age of 30 found that over 65% were unable to identify any of the six major cardiac risk factors. “In my short career, so far I have taken care of people who have had heart attacks in their 20’s and 30’s. These are people with high cholesterol in their 30’s, blood pressure issues starting in their teens.” The Women’s Heart Alliance 2014 survey reported that 45% of all women surveyed reported being unaware that cardiovascular disease was the leading cause of death for women. “We need to break the myth that heart disease doesn’t happen to us because it does – it is – and we are failing to identify it,” said Dr. Stahura.

Recognizing heart attack or stroke

“In movies and TV shows you see this picture of an older gentleman clutching his chest, having the “typical” signs of chest pain,” explained Dr. Stahura. In reality, heart attack symptoms aren’t the same for everyone, especially women. In a Twitter post from December 9, 2018, a female nurse shared her story. “I want to warn women our heart attacks feel different. Last Sunday I had a heart attack. I had a 95% block in my left anterior descending artery. I’m alive because I called 911. I never had chest pain. It wasn’t what you read in pamphlets. I had it off & on for weeks.” She called 911 after being drenched in sweat, after she started vomiting.

Women are more likely than men to have heart attack symptoms unrelated to chest pain. Dr. Stahura cautions women to listen to their body, to be aware of sensations, feelings, or severe pain that persists for more than 15 minutes. “A lot of women that I care for started with jaw pain or abnormal neck pain which came out of nowhere. A lot of women will have numbness, tingling in their hands, maybe some upper back pain where they think they did too much activity the day before. Acid reflux, consistently having reflux that is not improved with over the counter medications. These women are having a heart attack when I see them.”

Stroke is the third leading cause of death for women (in comparison, stroke is the fifth leading cause of death for men). Each year 55,000 more women have a stroke than men. “But when you ask the question, more people think it’s men. We need to talk more about the stroke risk for women,” proclaimed Dr. Stahura. Because in general women live longer than men, a stroke will have a more negative impact on their lives. The National Stroke Association states that more women will “live alone when they have a stroke, be more likely to live in a long term health care facility after a stroke, and have a worse recovery after stroke.”

Not only do women need to be aware of symptoms but they also need to respond faster during a cardiac emergency. A recent study conducted at the Triemli hospital in Zurich, Switzerland, found that women wait 37 minutes longer to seek treatment for heart attack compared to men. Dr. Stahura expressed this comes from not recognizing symptoms but also due to putting their family before their health needs. “I will ask women, ‘What caused you to wait, two days, three days, before seeking help?’ They tell me they have to care for their family. Women are tough. We have this innate sense of being caretakers, focusing on other’s needs before our own. Today, I want women to know, our health should be first too.”

Well Woman Visit

There is a reason National Wear Red Day falls at the beginning of American Heart Month. This month, health care professionals urge all women to discuss their heart health with their doctor. In the 2014 study by The Women’s Heart Alliance, approximately 71% of women did not mention heart health during a visit with a physician. “As a cardiologist, I will start by asking about your health history, what issues you have had in the past,” said Dr. Stahura. Expect a conversation on the risk factors that put you at an increased risk of heart disease. This would be blood pressure, high cholesterol, and if you’re a smoker. “I’ll also address your cancer history. Many patients that have had breast cancer, lymphomas, or leukemia and have had chemo or radiation, as well as therapies to the chest, that put them at risk of undiagnosed or undetected cardiovascular events.”

The goal of the Well Woman Visit is to asses your risk of heart disease and work with your physician on a plan live your best life. “Relationships are not built over one or two visits. I enjoy meeting with my patients and talking about their life. I want to hear about the areas of stress or changes in their life that could impact their overall health.”

Written by: Michael Arce, Marketing Coordinator, Capital Cardiology Associates
Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.

TEE Cardioversion Milestone

TEE Cardioversion Milestone

PRACTICE ANNOUNCEMENT

Milestone: 1,000th TEE Procedure Performed

at Capital Cardiology

20 months after opening

the “first of its kind service”

in New York State

With his staff and colleagues gathered around him as he stood on the counter to be heard, “On Tuesday, May 16, 2017, we did our first TEE (transesophageal echocardiography) procedure at Capital Cardiology Associates,” announced Dr. Jeffrey Uzzilia. “Today, Dr. (Kevin) Woods performed our 1,000th test!” The room applauded the success of the TEE Cardioversion Suite at Capital Cardiology, the first of its kind in New York State.

What is a TEE?

A TEE is a non-surgical outpatient procedure, where a small, flexible tube containing a probe is inserted into the esophagus to provide live images of the heart. The procedure usually takes about 30 minutes to complete. During the procedure, physicians, nurses and specialized staff observe your heart’s structure and function. Special attention is placed on the upper and lower chambers of the heart, the heart valves, and blood flow. After a stroke, this procedure is used to look for blood clots in the chambers of your heart as well as the examination of the heart after recent surgery.

“It’s kind of fun to do the impossible.” Walt Disney

The Road to a Milestone

In his speech to commemorate the 1,000th TEE test, Dr. Uzzilia shared how the idea to bring this procedure to the practice – rather than have patients go to the hospital – came to action. “Dr. Lance Sullenberger and I discussed the process at the hospital, the stress it added to our patients. I had different ideas about how to perform the TEE here. When we looked for a model to compare our idea, there is no model. Like a lot of innovations here at Capital Cardiology, we are the first to do this!”

Dr. Uzzilia and the echo team in a TEE procedure

Internally, the staff at CCA worked to convert a part of the building at Corporate Woods to a suite where the TEE procedure could be performed. “It took a lot of work from our team, from our check-in team working with patients arriving for the procedure to our Echo (echocardiography) staff learning new processes to figuring out how to modify and manage the patient flow in the room,” said Dr. Uzzilia. This included remodeling but also required obtaining the latest technology, put in the hands of a staff that specializes in this level of care and advanced medicine. A board-certified cardiologist performs the procedure with a team trained at this an exceptional level of cardiac medicine. Additionally, there is a board-certified cardiac anesthesiologist present for all TEE scans.

After a few months of converting the floorplan, training the team, and acquiring the technology, the TEE Cardioversion Suite at Capital Cardiology Associates opened for its first patient appointment on May 16, 2017. I had the honor of attending that groundbreaking procedure; you would have thought they had been performing this test for years. Since then, the physicians and their team at CCA have been performing TEE’s on Tuesdays.

Hitting 1,000

Reaching 1,000 of anything is quite an accomplishment. As Dr. Uzzilia announced hitting that number, I thought of two recent milestones mentioned in the neighboring days. One came a few days earlier, Sunday, January 20th, during the AFC Championship game between the New England Patriots and Kansas City Chiefs. As the Patriots were securing their advance to a record 11th Super Bowl appearance, the fact was stated that in his 24 years as the Head Coach of the Cleveland Browns and New England Patriots, Bill Belichick has coached in 384 professional football games. In his 44 years of coaching in professional football, starting as a Staff Assistant for the then Baltimore Colts in 1975, Coach Belichick still hasn’t hit 1,000 games. He’s only coached in 690.

NBC has been promoting the 1,000th episode milestone of “The Tonight Show with Jimmy Fallon” which made its debut from Studio 6B in Rockefeller Center on Feb. 17, 2014. The Winter Olympics coverage ran longer than expected on NBC that night, forcing Fallon to start his show at midnight. On his first broadcast, Jimmy collected a $100 bill from his first guest, Robert De Niro, who had once bet Fallon $100 that he would never host The Tonight Show. On Wednesday, January 23, 2018, Jimmy Fallon celebrated his 1,000th Tonight Show episode. It took him almost five years to reach that mark.

Those examples put in context the achievement of reaching the milestone of 1,000. It also showcases the unique combination of drive and passion you must possess to obtain that goal. Dr. Uzzilia recognized the leadership support he received in launching this idea. “I want to thank our CEO, Dr. Augustin DeLago, he was really supportive from day one, as he always is. If it’s better for patients and it’s something that we are willing to try and figure out, he is always willing to support us. It is the best feeling to come to work every day knowing that everyone wants to do the same thing: do what’s best for patients with an open mind to try something new, that has never been done before. I think that is why patients continue to come back here. We have such a caring group of people. I never hear from anyone at CCA, ‘Why are we doing this?’ I always hear, ‘Okay, how are we doing it?'”

Written by: Michael Arce, Marketing Coordinator, Capital Cardiology Associates
Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.

The Only to Offer WATCHMAN in the Capital Region

The Only to Offer WATCHMAN in the Capital Region

HEART HEALTH

The Only to Offer WATCHMAN in the Capital Region

New heart procedure could be a ‘game-changer’ for AFib patients in the Capital Region

Patients with atrial fibrillation (AFib) are at five times greater risk of developing stroke. Starting in 2015, Dr. Augustin DeLago, President of Capital Cardiology Associates, began practicing an alternative to treatment for patients with AFib known as The WATCHMAN. “The WATCHMAN is a device that doesn’t treat AFib, but it essentially blocks off an area of the heart where 90-95% of all blood clots form in patients with atrial fibrillation,” shared Dr. DeLago.

Today, Capital Cardiology Associates is proud to announce our practice is one of a handful of pioneers leading the way offering procedures and treatment to A-Fib patients. “We have implanted over 100 WATCHMAN devices, and Capital Cardiology Associates is the only center in the Capital Region offering this procedure,” stated Dr. DeLago.

An estimated five million Americans are affected by AFib an irregular heartbeat that feels like a quivering heart. People with untreated atrial fibrillation may be at higher risk for stroke than people with normal heart rhythms. Because blood does not flow through the atria regularly, blood clots may form in the heart. If a blood clot escapes from the heart, it can travel through the bloodstream to the brain and cause a stroke.

The WATCHMAN, which has been implanted in more than 50,000 patients worldwide, is a permanent implant device that closes off an area of the heart called the left atrial appendage (LAA) to keep harmful blood clots that can form in the LAA from entering the bloodstream and potentially causing a stroke. “I consider it the appendix of the heart, it’s a vestigial organ, you don’t need it,” said Dr. DeLago. “The LAA is important in embryonic development, but as an adult, you don’t need it. It’s only a place that harbors blood clots.” By closing off the LAA, the risk of stroke may be reduced and, over time, patients may be able to stop taking warfarin.

Patients with AFib may experience one or more of the following symptoms:
• Heart palpitations (a sudden pounding, fluttering, or racing feeling in the chest)
• Lack of energy, feeling tired
• Dizziness, or a sense of faintness or light-headedness
• Chest discomfort (pain, pressure, or tightness in the chest)
• Shortness of breath

Is The WATCHMAN right for you?

“There are a group of patients that have had previous bleeding on traditional blood thinners or the new medications that you see advertised like crazy on TV,” began Dr. DeLago. “They have had a previous event. I tell them that if you have had a major bleed while on one of these medications, your mortality rate can be as much as 13%. We tell them that they have to come off these medications because there is no alternative. With The WATCHMAN, we can give hope to the hopeless. We can put this device in and reduce their instance of stroke as if they were on COUMADIN (traditional blood thinner), giving them reduce stroke incidents without increasing their bleeding problems.”

If you have a history of bleeding or a lifestyle, occupation or condition that puts you at risk for bleeding, WATCHMAN may be right for you. But like any medical procedure, WATCHMAN comes with risks, so it isn’t right for everyone. Your cardiologist will weigh your risk of a stroke against your risk of a serious bleeding problem to determine the right treatment for you. For more information, patient education videos, or to schedule an appointment with our WATCHMEN team, click below.

Written by: Michael Arce, Media Specialist Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

World Stroke Day

World Stroke Day

Capital Cardiology Associates

World Stroke Day

Joining together for one day to fight the #2 cause of death in the world

Stroke is a leading cause of death around the world. But that’s just part of the story. 80 million people in the world have had a stroke, 50 million stroke survivors live with some form of permanent disability. The fact is, stroke is largely treatable and with healthy lifestyle changes, starting today, you can reduce your risk of becoming a statistic this year.

The World Stroke Organization is dedicated to improve care for stroke survivors worldwide.

What Happens

Director of Clinical Research, Dr. Robert Benton explains how a stroke event is similar to a heart attack. “Essentially for both of them you have an instance where you’re losing blood flow to a part of the brain or the heart. That is the common finding in both of them. In the heart, usually, this is caused by a cholesterol plaque that has become inflamed, ruptures because you are smoking, or because you have high blood pressure, and there’s a blood clot that forms and blocks blood flow to the heart. When the heart muscle doesn’t get blood, it dies. The brain is similar in that you can have plaque in your brain but the brain is also susceptible to other findings, that would be emboli that fly either from your neck, clotting breaking off from the arteries or the aorta, or one of the common causes of stroke called, atrial fibrillation (AFib).

Causes of Stroke

There are three main areas of stroke risk factors: lifestyle, medical, and uncontrollable. Dr. Benton advises that we work with our doctor to identify our personal risk factors for stroke as we would with heart disease. “Heart attack and stroke can have very similar risk factors that lead to them. Smoking, hypertension, high cholesterol, diabetes, a sedentary lifestyle… all of those things can contribute to your risk.” Tobacco use and smoking double the risk of stroke when compared to a nonsmoker. Smoking increases clot formation, thickens blood, and increases the amount of plaque buildup in the arteries. “People can have a genetic pre-disposition to stroke: high blood pressure, arrhythmia, cholesterol levels, these things can be genetically programmed. Then you do yourself no big favor by smoking cigarettes, eating a poor diet, not exercising where you can compound your genetic disposition for stroke with poor or bad lifestyle choices. Those two factors really work together,” pointed out Benton.

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Prevention Is The Best Cure For Stroke

The good news is, 80% of strokes can be prevented. “Strokes are as preventable as a heart attack and they are actually quite similar,” states Mary Ellen King, Nurse Practitioner at Capital Cardiology Associates. “With heart attacks people know eat a healthy diet, manage cholesterol, exercise and a stroke is the same thing.” Ultimately, regular visits with your healthcare provider will assess and monitor your risk for stroke.

Most importantly if you are over the age of 60 and haven’t been checked for AFib, see your doctor. “Most people with AFib don’t feel it. We find it on an EKG. Or a pacemaker, heart monitor, or they are wearing their FitBit or Apple Watch, whatever it is, they notice their heart rate is jumping all over the place and it’s faster than what it used to be.” Early detection of stroke is the biggest element in prevention. “The time piece of identifying stroke is so important because the longer that part of the brain goes without blood and oxygen supply, the worse the outcome is. Unfortunately, people live through strokes but they can be very debilitating and life altering,” explained King.

Monday, October 29th is World Stroke Day. Join Capital Cardiology and The World Stroke Association in the effort to raise awareness of stroke prevention, treatment and support. Meet with your doctor this fall to discuss your risk of stroke. If you are a stroke survivor, consider connecting with other members, partners, and survivors in the Capital Region by joining organizations involved with local support events.

Written by: Michael Arce, Media Specialist
Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.