Bret Michaels is not unique. Michaels, 47, the lead singer of the rock group Poison, had a mini-stroke or transient ischemic attack (TIA) a few weeks ago. A few days earlier, Beau Biden, the 41-year-old son of Vice President Joe Biden, suffered an apparent stroke as well.

The number of strokes is growing fastest in the 25- to 45-year-old group, according to data presented at the American Stroke Association’s International Stroke Conference 2010. One-third of the estimated 780,000 Americans who have strokes each year are under 65.

Hole in the heart

After Michaels’ stroke, doctors discovered he had a hole in the heart or patent foramen ovale (PFO), the most common type of heart defect. As many as 25 percent of Americans have a PFO, but many aren’t aware of it. It can increase a person’s stroke risk.

Everyone is born with an opening in the heart’s two chambers, but it closes shortly after birth for most people. In others, however, the flap does not close completely and can open when the chest is strained, such as during coughing or sneezing. Blood that has not been cleansed by passing through the lungs can flow through the flap, carrying debris and blood clots through the opening and into the bloodstream.

Like heart attacks, strokes are caused when a blood clot blocks an artery (ischemic stroke) or a blood vessel breaks (hemorrhagic stroke), interrupting blood flow to the brain. Blood clots can travel from any part of the body through the PFO. If those clots make their way through to the brain, they could cause a stroke.

Michaels is scheduled to have surgery in the fall to close the hole in his heart.

One of Western Baptist’s cardiologists, J. Kenneth Ford, M.D., was the first cardiologist in Kentucky to close adult PFOs.

Risk factors

Michaels has diabetes as well. An increase in the incidence of diabetes, high blood pressure and obesity – all risk factors for stroke – is a likely contributor to the increased number of strokes among young people. Other risk factors include smoking, high cholesterol, family history and lack of exercise.

Stroke is not just an old person’s disease, and it can cause a lifetime of disability among younger patients. Stroke is the leading cause of nursing home admissions and the third leading cause of death.

It is important for people of all ages to recognize stroke symptoms and act fast to receive medical attention. If you arrive at Western Baptist’s Emergency department within three hours after a stroke starts, you may be a candidate for tPA (tissue plasminogen activator), a clot-dissolving drug which can reverse or reduce stroke damage.

F.A.S.T. thinking

To determine if symptoms indicate a stroke, think F.A.S.T.:

•    F=Face   Ask the person to smile. Does one side of the face droop?

•    A=Arm  Ask the person to raise both arms. Does one arm drift downward?

•    S=Speech  Ask the person to repeat a simple phrase. Is the speech slurred or strange?

•    T=Time  If you observe any of these signs, phone 9-1-1 because ambulance staff can expedite treatment.

Western Baptist is making great strides in stroke treatment and will recognize stroke survivors at the American Heart Association’s Heart Walk this fall.

Chest Pain & Stroke Hotline

If you have questions about stroke symptoms, you can talk to a Western Baptist nurse free 24 hours a day on the Chest Pain & Stroke Hotline: 1-800-575-1911.

Send your questions!

Do you have a cardiac question tugging at your heart? Send it to heartbeat@bhsi.com or mail it to HeartBeat, 2501 Kentucky Ave., Paducah, KY 42003. If we use it in a future HeartBeat column, you will receive a Western Baptist Hospital door prize.