May is National Stroke Awareness Month - Are You at Risk?

May is National Stroke Awareness Month 

In a YouTube video titled "telling my story", model Hailey Bieber recently opened up about her March 10 health scare. The model and wife of singer, Justin Bieber, suffered a transient ischemic attack (TIA) which is a brief interruption of blood flow to part of the brain, spinal cord or retina, which may cause temporary stroke-like symptoms but does not damage brain cells or cause permanent disability. TIAs are often an early warning sign that a person is at risk of stroke - and this risk is especially high within 48 hours after a TIA.

Hailey said the cause of her TIA was a hole in her heart - a condition known as a patent foramen ovale or PFO and it’s a lot more common than people might think.   

Everyone has a PFO, or hole in their heart, at birth. It is a normal part of the circulation of a fetus. But, in most infants, this small hole naturally closes very soon after birth. When it does not close is when it can cause a problem later in life, like with Hailey who was eating breakfast when she began to exhibit stroke-like symptoms including numbness in her fingertips and drooping on the right side of her face. 

“Approximately 25% of the adult population has a PFO, for the vast majority of people, it’s not a problem, even though blood is leaking from the right atrium to the left,” explains Martin Gizzi, MD, PhD, director of the Division of Cerebrovascular Diseases and the Comprehensive Stroke Center at Hackensack University Medical Center. “The problem arises when that blood contains a blood clot.”

PFOs themselves don’t cause strokes, says Dr. Gizzi, but they provide a portal through which a blood clot might pass from the right to the left side. Depending on whether the clot takes a right or left turn as it exits the heart, it can travel to the brain and cause a stroke. 

“I was at work and started to feel tingling in my fingers that traveled up my right arm, all the way up to my eye,” explains Kareline Ortiz who at just 41, didn’t think she was at risk for a stroke. “Then my tongue went numb and I couldn’t speak and I knew something was really wrong.”

Kareline, a mother of two, was suffering from a TIA that was also caused by a PFO. 

Closing the PFO through an interventional heart procedure can reduce the risk of a second stroke in people who had a first stroke. Only about 1% of patients with a PFO experience a stroke, however, and among those, not everyone needs to have the closure procedure. That's where Hackensack University Medical Center’s new Heart-Brain Clinic comes in.

"We established this center to formally bring together heart and brain specialists to examine each patient, discuss their test results, and determine the best course of action for people with PFO who have had a stroke,” explains Dr. Gizzi. “It's not appropriate to close the PFO in everyone who has one, so we have to be selective."

The center enables patients, like Kareline, to see a structural cardiologist and stroke neurologist during the same visit. The team meets four times a month and offers patients services including diagnosis, evaluation, treatment and monitoring. 

Kareline underwent the procedure to close the hole in her heart at Hackensack University Medical Center and the whole experience has changed her outlook on life. “I’m healthy now but it was scary and I realized I need to reduce my stress level and spend more time with my family, which is exactly what I’m doing.”

Hailey Beiber underwent a PFO closure in California, where she lives and in her video says that she is doing well. This May, National Stroke Awareness Month, is a great time to spread awareness of this condition, the signs of a stroke, and the options available to patients. 

For an interview with a specialist from Hackensack University Medical Center and one of our patients, please contact [email protected].