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Thursday, July 31, 2014
Could this have been a TIA?
Hi - (Female, 49, not overweight, don`t smoke or drink, no family history of heart disease or stroke, sedentary lifestyle, angina, BP-mostly normal, cholesterol 213 (good ratio). A few weeks ago, I was sitting at my desk at work. No real stress, pretty calm. All of a sudden, my vision started to disappear from the top left corner diagonally down. It was like a shadow was walking into my peripheral vision, or a curtain was coming down, just bizzarre, so I turned to see what it was. There was nothing there and my vision came back. It didn`t last but maybe 5 seconds, but it was definitely weird. My blood pressure is usually fine (resting 117/77), but sometimes it spikes up to 180/90 for short periods (maybe an hour), usually when I`m stressed. I have angina and take Cartia XT and nitro (when needed). A friend said this could have been a TIA. My question is, since this episode was so brief, could it have been a TIA? And if so, how should I proceed? Thank you.
From your description, I think that a transient ischemic attack is one possible cause for your symptoms. Certainly, you wouldn't want to overlook a TIA.
There is a phenomenon called amaurosis fugax, which is a temporary loss of vision in one eye which is often described as a shade coming down over the eye, which is somewhat similar to what you described although you did not stipulate whether the loss of vision was in one eye or both. One potential cause of amaurosis fugax is a high-grade blockage (stenosis) of the internal carotid artery on the same side, which is something that might need medical attention.
I would recommend that you proceed by visiting with your primary care doctor as a first pass, and let him/her decide if a further visit to a specialist (such as a neurologist or an ophthalmologist) is necessary.
Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati