Is there chances for second heart attack?
Patient: My husband had a massive stroke 18 mths ago, lost his right side and speech.  We have been told that where he was at 6 mths is probably where he will stay. Also what are his chances of suffering another stroke.?  He is 72 yrs old, doesn't walk and speech is very poor.  I try to understand him but its so hard..People have told me I shouldn't try to care for him, but rather put him in a nursing home.  Am I killing myself? Doctor: Hello!Welcome and thank you for asking on HCM!I understand your concern and would explain that the chances of a stroke reoccurrence depend on his cardiovascular risk factors, the cause of his primary stroke and the preventive treatment that he is taking. I would like to have some more information on his current medication and on his past medical history and possible risk factors (smoking, high blood pressure, diabetes, atrial fibrillation). It is also necessary to know the situation of his cervical arteries (possible atherosklerotic plaques) and brain collateral circulation. With the best preventive therapy (anticoagulation or antiplatelet agents, coupled with statins and a better control of risk factors like hypertension and diabetes) the chances of re-occurrence would be up to 30-50%. It is also important to continue rehabilitation, even if 6 months have passed away. This will keep him active, avoid pneumonia and bed sores and also muscular spasticity which is a secondary complication of paralysis after stroke.  Hope you will find this answer helpful!Kind regards, Dr. Iliri