Heart attack and stroke risk may rise briefly after a bout of shingles

A painful, blistering rash known as shingles may temporarily increase a person's risk of a stroke or heart attack, according to a study in the Dec. 15, 2015 PLOS Medicine. Also known as herpes zoster, shingles results from a reactivation of the virus that causes chickenpox, which most adults had during childhood.
For the study, researchers analyzed the records of more than 67,000 people ages 65 and older diagnosed with shingles and either a heart attack or stroke from 2006 through 2011. They then compared the rates of cardiovascular events before and after a shingles attack. In the first week after a shingles diagnosis, the risk of a stroke rose 2.4 times and the risk of a heart attack increased 1.7 times compared with baseline risk.
About one in three people in the United States will develop shingles at some point. Experts recommend that people 60 and older receive a vaccine against shingles. But only 9% of the study participants had done so—not enough to determine if the vaccine could affect the risk of cardiovascular problems.
Other infections, including influenza and pneumonia, have also been linked to a transient increase in cardiovascular events. The authors postulate that the body's natural response to infections may promote inflammation. The resulting unhealthy changes in the arteries may trigger blood clots that can lead to a stroke or heart attack.

A heart attack and stroke are both potentially life-threatening conditions that require emergency medical care.
Combined, the two conditions affect 1.5 million people each year.
Both heart attacks and strokes can cause permanent damage to important organs, affecting quality of life and even causing death. Though a heart attack and stroke have several things in common, their symptoms, treatment, and recovery are different.

Contents of this article:

1. Causes of heart attacks and strokes
2. Heart attack and stroke treatment
3. Recovery from stroke and heart attack
4. Heart attack symptoms
5. Stroke symptoms

Causes of heart attacks and strokes

Atherosclerosis is a buildup of fatty plaque in arteries that can block blood flow.

The majority of strokes and heart attacks are caused by a disease known as atherosclerosis. This causes a buildup of a substance called plaque inside blood vessels.
Over time, the plaque can harden and break off, causing a blood clot to form on top of the plaque. The clot can block the blood vessel and starve vital organs of oxygen.
During most heart attacks, one of the heart's blood vessels, known as a coronary artery, becomes blocked by a clot. Part of the heart muscle rapidly loses its blood supply and may become permanently damaged.
Similarly, a stroke is often caused by the blockage of a blood vessel leading to the brain, known as a carotid artery. The clot robs the the brain of its vital blood supply and can lead to brain damage. This is why a stroke is sometimes called a "brain attack."

Heart attack and stroke treatment

Many heart attacks and strokes are caused by blocked arteries and blood clots. As a result, their treatment may be alike in several ways.
In both cases, a patient may receive clot-busting medicines in the hospital known as thrombolytics. These help dissolve the blood clot and restore blood flow to the affected organ. These medicines usually need to be given as soon as possible after symptoms begin, or at least within a few hours.
Clots in the coronary or carotid arteries may also be physically removed using an endovascular procedure. This is a non-surgical procedure that uses a thin tube to grab the clot and remove it or push it out of the way. Examples of this procedure are:

• Percutaneous coronary intervention (PCI) for heart attack
• Mechanical thrombectomy for stroke

Not all patients are candidates for a clot-removing procedure. If it is performed, it should be done as soon as possible after symptoms appear.

Recovery from stroke and heart attack

After a stroke or heart attack, many patients are prescribed medicines. These drugs can help by doing the following:

• Reducing future plaque buildup in the arteries
• Lowering blood pressure or cholesterol
• Reducing blood clots

These medicines may be used long-term to help avoid another heart attack or stroke.
Though some heart attack and stroke medicines may overlap, there are different treatments for each condition based on a patient's health history. Heart attack patients may get specific medicines that help reduce stress on the heart, prevent further heart damage, and relieve chest pain.
People with diabetes have an increased risk of stroke, so medications to help control blood sugar and diabetes may be prescribed for some stroke patients.
As many strokes and heart attacks are due to plaque buildup inside the arteries, either condition may involve certain lifestyle changes, including:

• Following a heart-healthy diet
• Getting exercise
• Quitting smoking
• Maintaining a healthy weight

These changes can help the body recover from the stroke or heart attack. They can also reduce the chances of having another one and promote general wellness.
The most important thing about a good recovery from a heart attack or stroke is getting treatment as soon as possible.

Different types of therapy for heart attack and stroke

Many heart attacks and strokes require some kind of rehabilitation or physical therapy. The type of therapy and goals of the treatment are usually quite different.
After a heart attack, a person may need cardiac rehabilitation. This is specialized therapy designed to improve heart health and is done under a doctor's supervision. Cardiac rehab usually includes:

• Exercise: A cardiac rehab specialist guides a person through exercise that is heart healthy and safe for them to do
• Information about living a heart healthy life: This includes a healthy diet, quitting smoking, and managing heart attack risk factors
• Stress reduction: Finding ways to manage stress can help improve heart health

Some basic physical therapy may be required after a heart attack or stroke.

Therapy after a stroke is quite different from a heart attack. If a person has suffered brain damage from a stroke, therapy may include a variety of exercises to help them relearn skills they may have lost.
Most strokes cause one of the following disabilities, which may be temporary or permanent:

• Problems with movement or paralysis of certain areas of the body
• Pain and headaches
• Trouble swallowing
• Changes in behavior or emotions
• Problems with thinking and memory
• Trouble talking or understanding others
• Uncontrolled urine leakage or bowel movements
• Changes to vision, taste, or smell

Heart attack and stroke are similar in many ways, but require different care and follow-up. Following a heart healthy lifestyle and regular doctor visits can help minimize the risk of these life-threatening conditions, but cannot prevent them completely.
The best way to increase the chances of survival and recovery is to learn the warning signs of heart attack and stroke and seek emergency medical care immediately should any symptoms appear.

Heart attack symptoms

Chest pain is one of most recognized symptoms of a heart attack. While it is the most common symptom, many people who experience a heart attack have little to no chest pain. These people may not realize they are having a heart attack or seek medical care as quickly as needed.
There are many other symptoms of heart attacks as well as chest pain. These symptoms may include:

• A feeling of pressure, fullness, or squeezing in the chest
• Pain in the jaw, neck, arms, back, or stomach
• Feeling short of breath
• Feeling lightheaded or fainting
• Cold sweats
• Nausea or vomiting

Women are more likely than men to experience nausea, vomiting, shortness of breath, and jaw pain.
Anyone who experiences these symptoms should seek care immediately. They are also advised to sit down and take an aspirin.

Stroke symptoms

There are two types of strokes: ischemic and hemorrhagic. Most people who have strokes have an ischemic stroke. These are usually caused by a blood clot in one of the brain's blood vessels. A hemorrhagic stroke is not caused by a blockage or plaque but by a burst artery.

People should seek medical care as soon as they experience any symptoms of heart attack or stroke.

A stroke can begin to damage the brain rapidly, leading to permanent disability or death. Stroke symptoms come on quickly, often with no warning. They may include:

• Drooping on one side of the face or being unable to move one side of the face
• Weakness or numbness in one arm - the person may be unable to raise both arms evenly out to their sides
• Slurred speech or difficulty talking - the person may not be able to repeat simple words or sentences clearly
• Loss of vision in one eye
• Loss of balance, falling, or dizziness

A transient ischemic attack (TIA) or "mini-stroke" produces symptoms just like a stroke, but they only last for a few minutes before going away. A TIA does not permanently damage the brain but they should not be ignored. About a third of people who have a TIA will have a stroke within a year.
Anyone who experiences possible stroke symptoms should see a doctor immediately, even if they come and go quickly.

Written by Jennifer Berry

 

Stroke and heart attack symptoms occur suddenly. Though the two events have a few possible symptoms in common, their other symptoms differ. A common symptom of a stroke is a sudden and powerful headache. A stroke is sometimes referred to as a “brain attack.” A heart attack, on the other hand, often occurs with chest pain.
Recognizing the different symptoms of a stroke and heart attack can make a big difference in getting the right kind of help.

What are the symptoms?

The symptoms of stroke and heart attack depend on:

• the severity of the episode
• your age
• your gender
• your overall health

The symptoms can come on quickly and without warning.

What are the causes?

Strokes and heart attacks both occur due to blocked arteries.

Stroke causes

A blood clot in an artery within the brain can cut off circulation to the brain. This can cause a stroke. The carotid arteries carry blood to the brain. Plaque buildup in a carotid artery can have the same result. These scenarios cause what is called an ischemic stroke. It’s the most common type of stroke.
The other main kind of stroke is a hemorrhagic stroke. That occurs when a blood vessel in the brain ruptures and blood leaks into surrounding tissue. High blood pressure that strains the walls of your arteries can cause a hemorrhagic stroke.
Learn more: What are the different types of strokes? »

Heart attack causes

A heart attack occurs when a coronary artery becomes blocked or narrows so much that blood flow stops or is severely restricted. A coronary artery is an artery that supplies blood to the heart muscle.
Blockage in a coronary artery can happen if a blood clot stops blood flow. It can also happen if too much cholesterol plaque builds up in the artery to the point at which circulation slows to a trickle or stops altogether.

What are the risk factors?

Many of the risk factors for stroke and heart attack are the same. These include:

• smoking
• high cholesterol
• high blood pressure
• age
• family history

High blood pressure and your blood vessels

High blood pressure strains the walls of your blood vessels. That makes them more rigid and less likely to expand as needed to maintain healthy circulation. Poor circulation can increase your risk of stroke and heart attack.

High blood pressure strains the walls of your blood vessels. That makes them more rigid and less likely to expand as needed to maintain healthy circulation. Poor circulation can increase your risk of stroke and heart attack.]
If you have a heart rhythm abnormality known as atrial fibrillation (AF), you also have an increased stroke risk. Because your heart doesn’t beat strongly during AF, blood can pool in your heart and form a clot. If that clot breaks free of your heart, it can travel toward your brain and cause an ischemic stroke.

How are heart attack and stroke diagnosed?

If you have stroke symptoms, your doctor will get a quick summary of symptoms and medical history. You’ll likely get a CT scan of the brain. This can show bleeding in the brain and areas of the brain that may have been affected by poor blood flow. Your doctor may also order an MRI.
A different set of tests is done to diagnose a heart attack. Your doctor will still want to know your symptoms and medical history. After that, they’ll use an electrocardiogram to check on the health of your heart muscle.
A blood test will also be done to check for enzymes that indicate a heart attack. Your doctor may also perform a cardiac catheterization. This test involves guiding a long, flexible tube through a blood vessel into the heart to check for blockage.

How are heart attack and stroke treated?

Treating the blockage responsible for a heart attack usually involves either coronary artery bypass grafting (CAGB) or angioplasty with a stent.
During a CABG, which is often referred to as “bypass surgery,” your doctor takes a blood vessel from another part of your body and attaches it to an artery that’s blocked. This reroutes blood flow around the clogged portion of the blood vessel.
Angioplasty is done using a catheter with a tiny balloon at its tip. Your doctor will insert a catheter into the blood vessel and inflate the balloon at the site of the blockage. The balloon squeezes the plaque against the walls of the artery to open it up for better blood flow. Sometimes, they’ll leave a little wire mesh tube, called a stent, in place to help keep the artery open.
After a heart attack and the subsequent treatment, you should participate in cardiac rehabilitation. Cardiac rehabilitation lasts several weeks and includes monitored exercise sessions and education about diet, lifestyle, and medications for better heart health. After that, you’ll need to continue exercising and eating a heart-healthy diet while avoiding things like smoking, too much alcohol, and stress.
That same healthy lifestyle is also recommended following treatment for a stroke. If you had an ischemic stroke and made it to the hospital within a few hours of symptoms starting, your doctor may give you a medication called tissue plasminogen activator, which helps break up a clot. They can also use tiny devices to retrieve a clot from blood vessels.
For a hemorrhagic stroke, you may need surgery to repair the damaged blood vessel. Your doctor may use a special clip in some cases to secure the part of a blood vessel that ruptured.

What is the outlook?

Your outlook following a stroke or heart attack depends greatly on the severity of the event and how quickly you get treatment.
Some people who have a stroke experience damage that will make walking or talking difficult for a long time. Others lose brain function that will never return. For many of those who were treated soon after symptoms began, complete recovery may be possible.
Following a heart attack, you can expect to resume most of the activities you enjoyed before if you do all of the following:

• follow your doctor’s orders
• participate in cardiac rehabilitation
• maintain a healthy lifestyle

Your life expectancy will depend greatly on whether you adhere to heart-healthy behaviors.
If you have a stroke or heart attack, it’s important to take the rehabilitation process seriously and stick with it. As challenging as it may be at times, the payoff is a much better quality of life.

Preventing heart attack and stroke

Many of the same strategies that can help prevent a stroke can also help reduce your chances of having a heart attack. These include:

• getting your cholesterol and blood pressure levels into a healthy range
• not smoking
• maintaining a healthy weight
• limiting your alcohol intake
• keeping your blood sugar under control
• exercising most, if not all, days of the week
• eating a diet that’s low in saturated fats, added sugars, and sodium

Read more: Foods to increase your HDL »
You can’t control certain risk factors, such as age and family health history. You can, however, live a healthy lifestyle that may help reduce your odds of having a heart attack or stroke.