Question

I am a 68-year-old female with high blood pressure, taking medications. I am taking one aspirin (325mg) daily. My cholesterol is normal. Yesterday I developed a light-headed feeling, followed by double-vision, for about 1 hour. During that time, my speech was slurred. Do you think this was a TIA? Should I pursue this aggressively or wait it out?

Answer

What you describe could possibly be a transient ischemic attack (TIA) despite your normal cholesterol and treated hypertension. The light-headedness may also be associated with a phenomenon called vaso-vagal syncope, where the relative blood flow to the brain is decreased due to sudden movement or a drop in blood pressure. This could be a side effect of your anti-hypertensive medication. It is also possible that even though your hypertension is treated and your cholesterol low, you may have enough atherosclerosis in your arteries to cause TIA's. Ask your doctor to pursue this it hasn't been done already. The appropriate study would be arterial sonography (Doppler studies) of your carotid artery, and possibly also cerebral angiography. The reason that I mention this is the neurological symptoms you described. And yes, you should aggressively address this.

One last comment about your daily aspirin usage. Current recommendations and studies clearly show that there is no added benefit in taking more than 81mg (one baby aspirin) a day. The full dose of 325mg may adversely affect your clotting mechanisms. Please discuss this with your physician also.