Do You Know the Warning Signs of a TIA?

Doctors, however, say it’s important not to overlook TIA symptoms. In fact, they require immediate medical attention, a recent scientific statement from the American Heart Association (AHA) says. Diagnosing a TIA and understanding its root cause can help prevent a full-blown stroke, which can cause lasting brain damage and long-term disability — even death. It’s estimated that 446 people in the U.S. die each day from stroke.

“TIAs can be a harbinger of something really bad,” says Arif Jivan, M.D., an interventional cardiologist at Northwestern Medicine Lake Forest Hospital. “It can be a warning sign for a more significant stroke in the future.”

According to the AHA, up to 18 percent of people who experience a TIA will have a stroke within three months — and half of those strokes will occur within a few days. About one-third of people who have a TIA go on to have a stroke within a year.

Several days after her first TIA, Bonness found herself back in the emergency room. This time the diagnosis was a stroke.

Know the TIA warning signs

The symptoms of TIA are the same as those for a stroke, doctors say, only they are temporary and can sometimes resolve as quickly as they come on.

Amin points to the acronym FAST to recognize the warning signs of both TIA and stroke. The first three letters stand for face drooping (typically on one side), arm weakness or numbness (again, this is usually on one side of the body) and speech difficulty, where an individual may struggle to string words together, say something nonsensical or have thick, slurred speech “where it sounds like the patient’s got marbles in their mouth,” Amin says.

The final letter stands for time to call 9-1-1, and the same holds true when it comes to TIA, even if the symptoms stop before you get to the phone.

Another symptom to pay attention to is vision change, Amin says. “The classic type of vision symptoms that suggest a stroke or TIA is a blackout of vision. So if someone notices complete vision loss in just one eye, and it’s described as kind of a nightshade coming down over one eye, if it’s temporary or if it’s lasting, that is an emergency,” he says.

In fact, some stroke awareness campaigns use the acronym BE FAST, with the “B” standing for balance and the “E” representing eye/vision changes. Thinking back, Bonness says had she known about BE FAST — she had at least three of the symptoms — she “probably would have gone to the ER sooner.”

“It’s imperative that we don’t ignore those symptoms and seek medical attention very quickly,” Jivan says. “Even though they’re transient and they’re short-lived, [TIAs] are associated with long-term, worse outcomes.”

Diagnosis and treatment can help prevent a stroke 

Doctors can diagnose a TIA with a series of tests in the emergency room, including imaging tests to look for signs of narrowing arteries that lead to the brain, and blood work to rule out other conditions that present with similar symptoms. After a diagnosis is established, cardiac tests may be ordered to assess heart risks that may have caused the TIA, such as atrial fibrillation, an irregular heart rhythm that can increase risk for stroke.

The AHA also recommends that physicians assess a patient’s risk of stroke after a TIA, taking into account their age and other stroke-related risk factors, such as diabetes, high cholesterol and high blood pressure. Those at high risk may be hospitalized. Patients at lower risk may be prescribed medications, like statins or blood thinners, or referred for surgery to open up a narrowed artery.

And because behaviors like smoking, poor nutrition and physical inactivity can increase the likelihood of TIA or stroke, many TIA patients are counseled on risk reduction.

“We think about how to best manage those risk factors to prevent something like that from happening again,” Jivan says. Research suggests that up to 80 percent of strokes after a TIA may be preventable when risk factors are managed.

After her stroke, Bonness, now 65, poured her focus into changing her lifestyle. In addition to taking medication for high blood pressure and high cholesterol, she altered her diet, set boundaries with her work and carved out time for creative projects, including poetry and memoir writing.

“Your lifestyle matters — so all the stuff they tell you about eating healthy and managing your stress would have helped prevent this TIA for me,” says Bonness, who fully recovered from her stroke and was eventually able to go off all her stroke-related medications. “And it certainly has helped me prevent any future strokes now, with the lifestyle that I take very seriously.”