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Medical English / By Tom Secrest

Strokes, once they occur the 3 hour clock is running / By Tom Secrest

Most people are pretty well informed about heart attack symptoms. We’ve seen them graphically depicted in movies and TV programs. Additionally, heart attacks are usually obvious. Sometimes the person isn’t sure what’s wrong, but they know something has happened and they know to seek medical attention. Such is not always the case with strokes.

Heart attacks and strokes are essentially the same process. It is unfortunate that we don’t use similar names. We could say “brain attack” or “heart stroke” and it would mean the same; plus, having similar terms might not only reduce confusion, it might even save lives. The most common cause of both heart attacks and strokes is severely reduced or blocked blood flow through a blood vessel. As a result all of the cells downstream from the blockage are deprived of both oxygen and nutrients. As time passes the deprivation leads to cell death (infarction). While cardiac muscle and brain cells (neurons) don’t seem to have much in common, they do share one feature, neither cell type can reproduce itself. Once the cells are dead, they are lost forever. In response to the lost cells, the body simply fills the area with scar tissue; however, scar tissue can’t pump blood or conduct electrical signals around your brain.

Strokes also present a unique problem, one less often seen in heart attacks. In many cases, as neurons die, they release of flood of chemicals that can kill healthy neighboring cells. This cascade effect means that cells that should have survived the stroke end up being killed by a toxic brew of chemicals released from the affected cells. The result is that damaged area in the brain can extend well beyond the infarcted area.

Currently, there is only one FDA approved drug that can be used to dissolve and remove the blockage that might have caused a stroke. The drug is tPA (tissue plasminogen activator) and this is the key, it MUST be used within 3 hours of the stroke onset to be effective.

So how do you recognize a stroke? The person, unless they are medical professionals, is rarely able to recognize that they have had a stroke. That means it is up to you!

You need to ask (maybe even insist) the person does four things.

1. S: Ask them to smile (the smile should be normal in appearance and symmetrical)

2. T: Ask them to talk (e.g. ask them what they did last weekend or yesterday); don’t ask them to repeat a sentence that you speak, the speech needs to be original. (speech should be fluent, meaningful and coherent)

3. R: Ask them to raise both arms over their head (the movement should be smooth and symmetrical)

4. S: Ask them to stick out their tongue (the tongue should come straight out and not off to one side)

If the person fails ANY of these tests, call emergency services at once and tell the dispatcher you suspect a stroke.

Remember, don’t hesitate, the clock is running.


  • stroke – mrtvice
  • occur – vyskytovat se
  • obvious – zřetelný, zjevný
  • essentially – v podstatě
  • confusion – zmatek
  • severely – vážně, hrozně
  • flow through – protéct (7. p.); protékat (7. p.)
  • blood vessel – céva
  • however – nicméně, ať tak nebo onak
  • damaged area – oblast znečištění
  • rarely – výjimečně
  • appearance – vzhled
  • tongue – jazyk
  • don't hesitate – neváhejte
  • damaged area – oblast poškození
  • dissolve and remove - rozpustit a odstranit


                                                                 About Tom Secrest / Tom Secrest online 



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