Slievemore Clinic

The Vascular Screening Program  is dedicated to improving your health and offering an array of screening services to help identify your risk for cardiovascular disease and stroke.  The News and Updates page will keep you abreast of the latest developments with the Vascular Screening Program and the latest news on new medical breakthroughs.

The Importance of Stroke Awareness and Preventive Screening

Disease of the circulatory system accounts for 41% of all deaths in Ireland and is the leading cause of death in the country (Dept. of Health & Children 2009).  Stroke is a circulatory disease that affects 40,000 Irish people each year.  One out of every four strokes is fatal and the majority result in permanent disability (Irish Heart Foundation 2008).  A recent study conducted at Mid-Western Regional Hospital in Limerick reported that 40% of stroke patients died and another 40% were still in institutional care 4 years following the stroke (Walsh 2008).

Stroke develops when blood flow to the brain is blocked by a blood clot (ischemic stroke) or by a vessel that breaks (hemorrhagic stroke).  When blood flow to areas of the brain is blocked, that region of the brain begins to die.  Most strokes, about 80%, are ischemic.  Strokes occur in men and women alike and the risk for stroke doubles for every 10 years past the age of 55.  However, stroke can occur at any age.  Early detection and treatment of this dreaded event could save thousands of lives each year.

Some strokes may be successfully treated with prompt treatment, within 2 hours after the onset of stroke symptoms.  Beyond 2 hours, the risk for permanent disability increases exponentially with every hour that passes.  The most common stroke symptoms include the sudden onset of any of the following:
• Numbness or weakness, especially on one side of the body
• Confusion, or difficulty speaking or understanding
• Vision problems
• Trouble with walking, dizziness, or loss of coordination
• Severe headache with no known cause

Unfortunately, only 5% of stroke victims are admitted to a hospital within 2 hours.  This may be, in part, because many stroke victims have no detectable symptoms.  Another reason for these long delays between stroke symptom onset and hospital admission is that most people do not recognize that they are having a stroke until it is too late.  Assessment of your stroke risk, before it happens can help you take preventative action while you still have time.

Detection of plaque buildup in the carotid artery, the main vessel supplying blood to the brain, can help determine your future stroke risk.  Plaque can reduce blood flow to the brain or pieces can break off and block blood flow entirely.  Doppler ultrasound screening of the carotid artery is a well-established method to diagnose carotid artery plaque buildup (Geroulakos 1996), and is quick and inexpensive with the ability to detect narrowing of the artery with high accuracy, around 94% of the time (Wolff 2007).  The National Men’s Health Policy (Dept. of Health & Children 2008) supports the use of preventative, accessible, health screening, such as the Vascular Screenings offered by this program, as an effective method to recognize potentially life-threatening complications such as stroke.  If the carotid Doppler ultrasound determines your stroke risk is high, these results can be provided to your physician to allow time to consider treatment alternatives before a stroke occurs.

The Importance of Preventive Stroke Screening

Stroke is the second leading cause of death and is responsible for the disability of 30,000 people in Ireland.  Patient outcomes following a stroke are dismal, 1/3 of patients will die, 1/3 will suffer permanent disability, and only 1/3 will recover to normal functioning.  Although stroke victims that receive prompt treatment have better odds of recovery, most people do not know the most common symptoms of a stroke.  This prevents 95% of stroke victims from receiving timely treatment.  Furthermore, most strokes occur with no warning signs, which highlights the importance of preventive screening for this dreaded event.  The message is clear, waiting until a stroke occurs before taking action can be a fatal mistake.

One of the main causes of stroke is narrowing of the carotid artery by plaque accumulation.  Plaque can also be dislodged and block blood flow to the brain.  The chances of having a stroke depend on the amount of blood flow to the brain and degree of artery blockage.  Fortunately, most strokes are preventable by identifying stroke risk and receiving appropriate treatment, if needed.

There are currently no screening methods that can predict stroke with certainty.  There are, however, several tests available to assess the health of the carotid artery.  Most tests are expensive, invasive, and may involve radiation exposure.  One method, Doppler ultrasound, is fast (20-30 minutes), painless, radiation-free, and less expensive than other tests such as MRI and CT scans.  There are no risks with the carotid ultrasound because images of the carotid artery are produced with harmless sound waves, the same ultrasound technology used to see images of fetuses in pregnant women.  Doppler ultrasound measures the levels of plaque and the speed of blood flow in the carotid artery, the results of this test can predict your risk of future stroke.  Finally, Doppler ultrasound detects disease of the carotid artery with 94% accuracy, comparable to that of the more expensive and riskier tests available to patients today (Wolff 2007).

People at highest risk for stroke, and who could therefore benefit the most from preventive stroke screening are those who have any one of the following risk factors:
•    High blood pressure
•    High cholesterol
•    Heart disease
•    Diabetes
•    Smoke cigarettes
•    History of transient ischemic attacks, or “mini-strokes”
•    Have ever been diagnosed with a bruit, or abnormal sound in the carotid artery
•    Age 50 or older, or a family history of any of these disorders, regardless of age

The Department of Health and Children encourages the use of preventative screening measures, especially community outreach programs, to enable people to make lifestyle modifications and reduce the risk of life-threatening diseases like stroke.  Additionally, the Irish College of General Practitioners supports efforts for better community access to health services, especially for those that pose serious health threats.  The Vascular Screening Program is an initiative that complements these nationwide initiatives and can help to identify stroke risk early, potentially saving thousands of lives each year.