Patient information · Emergency and cardiovascular
Stroke and the FAST test
every minute costs brain tissue
A stroke is a brain attack — blood supply to part of the brain is cut off, and around two million nerve cells die every minute it continues. Clot-busting treatment works only within a narrow window. Recognising it and dialling 999 immediately is the single most useful thing anyone can do.
Call 999 immediately — think FAST
- F — Face. Has their face fallen on one side? Can they smile?
- A — Arms. Can they raise both arms and keep them there?
- S — Speech. Is it slurred? Can they understand you?
- T — Time. If you see any single one of these signs, call 999 now.
- Also call 999 for sudden loss of vision, severe unexplained headache, sudden dizziness with loss of balance, or sudden confusion
Do not drive them to hospital, do not wait to see if it passes, and do not give aspirin, food or drink. Note the exact time symptoms started — treatment decisions depend on it. Stay with them, keep them comfortable, and unlock the door for paramedics. In an emergency call 999; the nearest emergency department is the Royal London Hospital, Whitechapel Road, London E1 1FR, which is a major stroke centre.
Signs beyond FAST
FAST catches most strokes but not all. Also treat as an emergency: sudden numbness or weakness anywhere on one side; sudden trouble seeing in one or both eyes; sudden severe headache with no known cause; sudden difficulty walking, dizziness or loss of coordination; sudden confusion or difficulty understanding.
A mini-stroke is not a lesser event
A transient ischaemic attack produces the same symptoms but they resolve, often within minutes. People routinely decide it must have been nothing. In fact a TIA is a warning that a full stroke may be imminent — the risk is highest in the first few days. Call 999 if symptoms are present, and seek same-day assessment even if they have completely gone. Prompt treatment after a TIA substantially reduces the chance of a stroke following.
Who is at higher risk
- High blood pressure — the single biggest modifiable risk factor, and usually silent
- Atrial fibrillation — an irregular pulse, which multiplies stroke risk several-fold and is often undiagnosed
- high cholesterol, diabetes, smoking, excess alcohol
- being overweight and physically inactive
- South Asian, African and Caribbean heritage, which carries higher risk at younger ages
- a previous stroke or TIA, and a family history
Reducing your risk
- Know your blood pressure. It causes no symptoms until it causes a stroke.
- Check your pulse for irregularity — 30 seconds at the wrist. AF is irregularly irregular, with no pattern to the gaps.
- Stop smoking; this halves stroke risk within a few years.
- Keep alcohol within 14 units a week, spread out.
- 150 minutes of activity a week, and treat diabetes and cholesterol properly.
- If you have AF, take anticoagulation as prescribed — it is the intervention that prevents most strokes.
After a stroke or TIA
Recovery continues for months and sometimes years, and the risk of a further event is highest in the first weeks. Blood pressure, cholesterol, glucose, heart rhythm and medication adherence all need reviewing and keeping under review — this is where the second stroke is prevented.
Come to us for the prevention, not the emergency. If you are having stroke symptoms, call 999. But if you want your blood pressure, pulse rhythm, cholesterol and glucose checked properly, have a family history that worries you, or need follow-up and medication review after a TIA or stroke, that is exactly what we do. We offer ECG, echocardiography and blood tests in-house, cardiology consultations without a referral, and unhurried appointments seven days a week — with a written summary to take away.
Stroke risk assessment, seven days a week
ECG, echo and bloods in-house, cardiology without a referral. In an emergency call 999.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.