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A-fib & the Silent Stroke: September 30, 2013

Atrial fibrillation- or a-fib, has long been linked to a higher stroke risk- the condition means the upper chamber of the heart is offbeat. Often quivering instead of contracting the way it should. The danger arises if leftover blood pools in the heart, which can cause clots to form.

“If the blood clot leaves the heart the first two blood vessels that exit from the heart actually go to the brain and so there is a risk that a stroke could ensue,” says Dr. Richard Chazal, cardiologist with Lee Memorial Health System.

These strokes can be catastrophic and leave lasting damage. But now research is linking a-fib to so-called ‘silent strokes’.

“We can identify on a CAT scan or MRI a small area of the brain that actually has some damaged but wasn’t manifested clinically. And in other words the personal can’t recall an event where he or she was paralyzed or couldn’t speak- had a sudden difficulty- but we can identify that person did have some damage to the brain or had a stroke at one time or another,” says Dr. Chazal.

The arrhythmia correlated with 7.2-fold higher risk of having at least one silent stroke that showed up on MRI. This excluded people who were already on blood thinners.

“A significant percentage of people with atrial fibrillation if studied very carefully have had a very small silent stroke,” says Dr. Chazal.

Up to now a-fib was linked to symptomatic stroke along with TIA or mini strokes. This new connection to silent strokes opens discussion about putting more people on stroke reducing blood thinners.

“Bottom line is, one must consult his or her physician to make certain there’s a careful analysis of the risk and the benefit in terms of therapy,” says Dr. Chazal.

So the topic of silent stroke might be a conversation-starter between you and your doctor.