Dr. Viktoria Totoraitis, Medical Direc- tor of the stroke program at NCH. With younger people, she says, strokes are generally not caused by disease in the blood vessels, usually the culprit in older people. Older people who have strokes often have atrial fibrillation, plaque buildup in the arteries and other vessel-related problems. Many of these problems can be exacerbated by lifestyle factors, such as smoking and high cho- lesterol. In younger stroke patients, life- style factors are generally not to blame. STROKES IN YOUNGER PEOPLE When she sees a stroke in a younger person, Dr. Totoraitis says, the strokes generally are not caused by lifestyle fac- tors like smoking or poor diet. Younger patients may have cardiac anomalies that they were born with. “For example,” she says, “there could be a weakness in one of their blood vessels that has always been there. Or they could be missing a vessel, or a vessel may be too small.” Another possibility she screens for is an autoimmune disorder, such as lupus. She will perform a rheumatologi- cal screen on younger patients to help determine if this factor is at play. Another test she will perform is an echocardiogram (ECG), to check the IN YOUNGER STROKE PAT IENTS , LIFESTYLE FACTORS ARE GENERALLY
NOT TO BLAME .
24 NAPLES HEALTH APRIL - JUNE 2019
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