Medically Reviewed by Christopher G. Cunningham, MD

Our region has much to be proud of. However, being #1 in the county for arterial diseases, such as strokes, is not an honor so much as an indication we can do better. McLeod Vascular Surgeon Christopher Cunningham, MD offers this important background.

Here’s a summary of Dr. Cunningham’s remarks:

Arterial disease is rampant in the United States. And it’s more prominent in South Carolina than about anywhere in the country. The Pee Dee region is the #1 County in the United States for stroke rates. Peripheral arterial disease that blocks arteries to the leg (and results in people losing their legs) is high. And so are diseases of the big blood pipe—your aorta.

As a country, we’ve done a really good job educating about heart disease. Everyone knows if you have chest pain – and it feels like you’re being crushed – you’re suppose to take an aspirin and call 911.

Since the 1960s, the American Heart Association has done wonderful public education. As a result, we’re living longer than ever.

In the 1960s, men use to die at 55-65 years of age of a big heart attack. Women never smoked at all before WWII. But in WWII women started smoking ferociously. And 30 years later, beginning in 1974, lung cancer, heart disease, and arterial disease started to go through the roof, just like their male counterparts.

A stroke is something that kills a part of your brain. In a heart attack, something blocks the artery to your heart, killing a part of your heart. With a stroke, a blocked artery to your brain (or some other mechanisms) injures brain tissue. Strokes occur for three primary reasons.

One class of strokes is called hemorrhagic, caused by bleeding. Primarily, this happens to people, who have untreated, severe high blood pressure. It’s like the thermometer in the old cartoon. If the pressure and the heat continue to rise, pretty soon the top blows off the thermometer. The same thing happens in the body. As your blood pressure rises in your brain, small vessels can rupture. Once you start bleeding into your skull, only bad things can happen.

The number one way to avoid hemorrhagic strokes is to take good care of controlling your blood pressure.

The second type of stroke is called embolic. That means a solid piece of plaque in your blood stream is blocking an artery. There are two major causes of embolic stroke – atrial fibrillationand valvular heart disease. In your heart, the top part is supposed to pump and then the bottom part pumps. Atrial fibrillation – our most common cardiac arrhythmia – the top of the heart quivers, while the bottom keeps doing its job. If you have a large bag of blood you’re not pumping, it’s not moving and likely to form a clot.

If a heart remained in Afib, it wouldn’t be such a bad thing. But every now and then the top of the heart will pump hard, pushing the blood with the clot out of the heart into the aorta. It can go to your brain, causing a stroke. It can go to your intestine, causing pain and death of the intestine. It can go down to your legs, causing pain. Blood flow needs to be restored within 6 hours or you’ll start losing part of your legs.

The major causes of stroke are something I treat every day. An embolic stroke is a stroke in the carotid artery. The carotid artery carries 90% of the blood to the brain. A narrowing in these arteries can break off small clots that can block arteries within the brain. The causes cell death to those parts of the brain and that is called a stroke.

You may also find these articles helpful:

Atrial Fibrillation: Erratic Heartbeats

4 Tips on Spotting a Stroke F.A.S.T.

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