Stroke and Heart Procedures: What You Need to Know

Hearing your doctor, or your loved one’s doctor, tell you that heart surgery is the best course of action can be a scary moment. There are so many questions and concerns that it can become overwhelming. But educating yourself on the process and potential risks and outcomes can help you mentally prepare and relieve some of the anxiety and stress.

If you’ve already done some research, you may have discovered that many heart procedures carry a risk of stroke. This includes valve replacement procedures such as TAVI (transcatheter aortic valve implantation). Before undergoing this life-changing procedure, learn more about what a stroke is, the signs, and how you can prevent it.

What is a Stroke?

Strokes are classified into two types, but the most common type is called an ischemic stroke. An ischemic stroke can occur when the arteries to your brain become narrowed or blocked, which reduces blood flow to the brain and leaves it deprived of oxygen. Without adequate oxygen, brain cells begin to die, resulting in permanent damage and potentially death. Approximately 85 percent of strokes are ischemic strokes.

The most common ischemic strokes that result from heart procedures occur when a blood clot or other debris forms in another part of the body (most often in the heart) and is swept through the bloodstream to the arteries of the brain, creating a blockage. Strokes can occur during the procedure, shortly after, or during recovery.

What are the Signs of a Stroke?

Symptoms can be sudden and clustered, or they can be subtle and isolated. Recognizing them and acting quickly can save a life. The most discernable signs include:

  • Drooping or sagging of the face, particularly to one side
  • Sudden onset of slurred or impaired speech and/or confusion
  • Sudden weakness or numbing, particularly to one side of the body
  • Sudden and severe headache
  • Impaired vision, loss of balance and/or dizziness

Other potentially less noticeable signs of a stroke or neurological damage include:

  • Decreased attention and difficulty with memory
  • Movement and balance problems
  • Changes in behavior

Even if the traditional signs of the stroke are not exhibited, debris can still cause cerebral lesions that may lead to stroke, or what is known as cerebral infarcts, later down the road. These infarcts can still have neurological and cognitive consequences, such as impaired mobility, physical decline, depression, cognitive dysfunction, and dementia.

How Can Stroke be Prevented?

Some studies suggest that lifestyle habits leading up to the heart procedure play a part in stroke risk. The most preventative measures for stroke are tied to a healthy lifestyle, including a balanced diet, regular exercise, limiting alcohol intake, abstaining from smoking, and regulating stress.

Another preventative measure is to maintain an ongoing dialog with your doctor. Your Heart Team will know what’s best for your particular situation, so being honest about your lifestyle, symptoms and concerns is critical. Prior to your heart procedure, talk to your doctor about measures his or her team will be taking to prevent stroke. For example, if you are preparing for a TAVI procedure, ask your Heart Team if cerebral embolic protection is available to you. A cerebral embolic protection device deployed during the TAVR procedure can capture and remove debris before it reaches the brain, offering an extra layer of protection against the risk of stroke.

As with any procedure, it’s important to ask questions and discuss any concerns you may have about the potential risks. And if you or your loved one is exhibiting signs of a stroke, seek medical attention right away.