Dysfunction may be caused by TIAs

Dear Dr. Gott: I am 63, healthy and in fair physical shape. I began to notice some disturbing incidents about two years ago. I met a man at a business function, spent four hours with him and did not recognize him the next day. On another occasion, I did not recognize several of my co-workers. While driving home one night, I suddenly became aware that I was not functioning properly and narrowly avoided an accident. Also, I don’t remember conversations and names.

What causes these memory lapses?

Dear Reader: I cannot tell, based on the sparse information you supplied. Nonetheless, I am concerned that you may be suffering from transient ischemic attacks (TIAs) – small strokes that cause only temporary dysfunction.

Without a doubt, you need further testing and analysis. Therefore, I recommend that you undergo an evaluation by a neurologist. Such a specialist will examine your nervous system and obtain imaging studies, such as an MRI of your brain.

If, indeed, you are suffering from small strokes, you are in danger of a larger stroke and significant handicap. This situation is treatable; permanent disability is preventable. Ask your doctor for the necessary referral to the specialist.

To give you related information, I am sending you a copy of my Health Report “Strokes.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: I’m 79 and in good health except for atrial flutter. I remain active and have not required medication until I recently experienced a pulse rate of 150. At this time, my doctor prescribed Cardizem to control the rate. He also wanted to refer me to a cardiologist for a procedure called catheter ablation. What do you think of this?

Dear Reader: I agree wholeheartedly with your doctor. You need a cardiology consult. I am less convinced that you need an ablation, which is an invasive event during which a specialist threads a catheter into your heart and attempts to identify the source of your rapid pulse. If he is successful, he may be able to disarm the area of your heart that is responsible for your maverick rhythm.

Atrial flutter is an electrical condition marked by extremely rapid contractions of the atria (the low-pressure chambers) to which the ventricles (the high-pressure chambers) respond more slowly, sometimes erratically. You would be better off resolving the complex electrical activity in your heart.

However, ablation may not be appropriate for you. In such a case, medicines to control your pulse rate may be the preferred treatment. The cardiologist can advise you and offer various options for you to consider. The specialist can also determine if you are a candidate for anticoagulation with Coumadin to prevent strokes from occurring.