NEW ORLEANS, Feb 10 (Reuters Health) -- Patients who seek treatment from
primary care physicians after experiencing a transient ischemic attack (TIA) are
not likely to be admitted to a hospital, undergo special scans to assess their
stroke risk or be referred to a specialist, study results show.
TIAs are temporary stroke-like symptoms, such as sudden weakness of the
face, arm or leg; loss of vision; dizziness; or trouble speaking. Patients fully
recover, but must take these symptoms seriously because they are important
danger signs of stroke.
According to Dr. Larry B. Goldstein of Duke University in Durham, North
Carolina, and colleagues, patients who experience a TIA or stroke are likely to
contact their primary care physician instead of emergency physicians because
patients are not aware of the risks associated with TIAs.
Goldstein and colleagues reviewed the cases of 176 patients who contacted
their primary care physicians due to symptoms of either a TIA or stroke. None of
the patients had a history of cerebrovascular disease.
The results of the study, presented here at the annual meeting of the
American Stroke Association, showed that 6% of patients who went to their
primary care physicians after experiencing TIA were admitted to a hospital for
evaluation and treatment on the same day, while 3% were admitted within a month.
Furthermore, primary care physicians consulted specialists in 45% of the
cases and ordered brain-imaging studies in 27%, regardless of whether the
patients were referred to a specialist. The results also showed that physicians
obtained carotid ultrasound studies in 25% of cases, electrocardiograms in 19%,
and echocardiograms in 16%.
"This tells me that many primary care physicians do not know enough about
TIAs, specifically about their risks," Goldstein said in the presentation.
"Primary care physicians, and to an extent even the lay public, should be
educated about TIAs and the outcomes associated with them."
"This is a serious and dangerous event, and people should understand the
risks it comes with," he said. "That means better management and better
understanding of what TIAs are, what the symptoms are, and who can help you best
if you develop symptoms."
