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Maloney's message: Get an artery scan and pay attention to risk factors, says stroke survivor

 

Prior to his stroke, Sean Maloney, a lifelong athlete who maintained a healthy diet and lifestyle and had yearly medical checkups, was not considered at high risk.

"Sean was more fit than I was, and I'm pretty fit," Margaret Maloney said. "But some people are more prone to plaque buildup."

Nearly 800,000 Americans each year experience a stroke, costing 128,000 lives and $73.7 billion in medical and disability costs. And yet 80 percent of strokes and heart attacks are preventable, according to the American Heart Association and the American Stroke Association.

Key things people can do to minimize their risk of stroke are to control their blood pressure, avoid smoking, get 30 minutes of exercise most days of the week and talk to their primary-care physicians about the need for medications such as aspirin or cholesterol-lowering drugs, Stanford University neurologist Maarten Lansberg said.

People also should learn the symptoms of stroke (face drooping, arm weakness, speech difficulty) and get a victim to the emergency room immediately, he said.

Maloney would add an additional recommendation for stroke prevention, one that is currently not standard practice among primary-care physicians: Get a carotid artery ultrasound if you are over 40 to determine whether there is blockage or narrowing in the arteries. Had he been given such a scan in the months prior to the event, Maloney believes his stroke would not have happened.

"If you don't get an ultrasound, you don't know whether or not you have the problem," he said.

San Jose resident Victoria Dupuy, whose husband Dean, a 46-year-old Apple engineering manager, collapsed and died of a heart attack in 2013 while playing ice hockey, echoes Maloney's plea for wider use of scanning technology as a preventive screening measure. Dean Dupuy had gone for his annual checkups, had no known risk factors and, just hours before his collapse, happily completed a "muddy buddy" running and bicycling obstacle course with his teenage daughter.

His widow has launched "No More Broken Hearts," a nonprofit group aimed at creating awareness about why seemingly healthy people have heart attacks and the need for heart screenings even in low-risk, asymptomatic individuals.

"Heart attacks occur without warning to even those who have no symptoms of heart disease and appear very healthy," Victoria Dupuy said. "At No More Broken Hearts, we want to see a world where these screenings are a routine part of one's physicals, just like mammograms and colonoscopies."

But current medical guidelines do not recommend carotid-artery ultrasound for asymptomatic individuals, neurologist Lansberg said.

"If you have already had a stroke or TIA (transient ischemic attack, or mini-stroke) it is important to get your carotid arteries checked because early treatment of blocked carotid arteries (a surgery called carotid endarterectomy, or CEA) can help prevent a second stroke," he said.

"If you have not had a stroke or TIA, current guidelines do not recommend screening for carotid stenosis (narrowing) with carotid-artery ultrasound because it is uncertain if patients with so-called 'asymptomatic' carotid stenosis benefit from (the surgery) or carotid stenting."

However, the National Institutes of Health is currently funding a trial to determine whether asymptomatic individuals who have taken the ultrasound and been diagnosed with carotid-artery stenosis could benefit from the surgery or carotid stenting over the standard medical treatment, Lansberg said.

The trial is called the Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Study, or CREST-2. For more information, go to crest2trial.org.

If you're going

Victoria Dupuy, director of No More Broken Hearts, invites the public to a free showing of "The Widowmaker," a 2014 documentary that promotes the coronary calcium scan, a screening that Dupuy believes would have saved her husband's life. The movie will be screened on Saturday, March 21, at 11 a.m. at the Guild Theatre in Menlo Park. For more information, call 650-566-8367.

Chris Kenrick

Comments

2 people like this
Posted by Worried
a resident of Another Palo Alto neighborhood
on Mar 13, 2015 at 6:48 pm

Having known Sean Maloney for over 15 years, many of us who know him are fearful for the future of his health now that he lives in China.

Those of us who have lived there know that if a person gets seriously ill, doctors and nurses have to be heavily bribed to give good hospital care--especially if you are not Chinese.

Most of us fear that this move will be the death of him--once you have a stroke, it is more likely to happen a second time.

Worse, he sold his house in Palo Alto. Perhaps he still has a home in Ireland or England? If he has another stroke, time is of the essence!


Like this comment
Posted by Cyclist for Life
a resident of Palo Verde
on Mar 14, 2015 at 4:37 pm

Hi Worried-
I'm a good friend of Sean's and you'll be happy to know that Sean has returned from China and received the best of care from a team at Stanford Medical.

Thank you for your concern.


2 people like this
Posted by Kathryn
a resident of another community
on Mar 16, 2015 at 8:56 am

One of the best, short and sweet articles I've read on the need for these non-invasive tests for people over the age of 40. Waiting for symptoms is simply too late, and I know too many people in their 40s, seemingly healthy, who are dying from heart attacks. We have to find a way to have insurance cover these simple tests as a part of regular exams. The coronary calcium scan could be done in the early 40s and then not again for several years if there are no signs of trouble, so this doesn't have to be an annual exam like mammograms. The costs of heart attacks, strokes, and then disability for those who survive are so enormous, there has to be an incentive for the insurance companies to cover these. Kudos to Sean and Victoria for continuing to spread this life-saving message.


1 person likes this
Posted by musical
a resident of Palo Verde
on Mar 16, 2015 at 11:10 am

@Kathryn -- careful not to confuse coronary calcium scan with carotid artery ultrasound.


1 person likes this
Posted by Brian
a resident of Crescent Park
on Mar 18, 2015 at 10:34 am

The article does not mention(unless I missed it) where the Sunday event begins. 3 miles from HP doesn't tell us a lot.
Thanks


Like this comment
Posted by Chris Kenrick
a resident of Old Palo Alto
on Mar 18, 2015 at 10:45 am

Brian,
The event is Sunday from 10 am until noon in front of Palo Alto City Hall. See www.heartacrossamerica.org for more information.


1 person likes this
Posted by Irishman
a resident of Leland Manor/Garland Drive
on Mar 18, 2015 at 8:02 pm

I am Irish, as is Sean Maloney. In 2006, I developed double pneumonia, for which I was hospitalized. During this hospitalization, I developed unusual cardiac arrhythmias.

a cardiologist was called in, and he ran some blood tests that were sent to Berkeley, after he learned of my heritage.

As it turned out, people of Celtic descent usually carry a genetic marker that allows their livers to produce too much cholesterol, even if no cholesterol is consumed. That was the case with me: a vegetarian for thirty years, my cholersterol reading were far too high. I was in danger of a heart attack or stroke at the age of 46 due to a marker I carried.

The cardiologist informed me I must NEVER consume animal fat of ANY kind, even if my weight dropped too low.

I became a vegan, and my cholesterol level is now only slightly above normal.

This may have been the problem for Mr Maloney as well, but it requires a very specialized blood test that only a cardiologist cn order!



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