The idea of starting an exercise program after suffering from a transient ischemic attack can be daunting to some patients.
People who’ve had a TIA will often wonder if it’s safe to exercise.
A TIA (transient ischemic attack) is a mini stroke, or, to put it another way, a temporary stroke, caused by a blood clot that chokes off blood supply to part of the brain.
TIA symptoms (weakness or numbness or heaviness on one side of body, unsteady gait, loss of balance, vision disturbances, severe headache, slurred speech, confusion) will last a few minutes to up to 24 hours, then spontaneously resolve.
Since high blood pressure is a major risk factor for stroke, and exercise increases blood pressure, you absolutely must delay your next workout session until you have had clearance from a cardiologist to resume (or begin) exercise.
“Exercising in individuals who may have had a TIA is dangerous,” says Teresa Caulin-Glaser, MD, a cardiologist and senior vice president with Service Lines, OhioHealth.
“It is important for individuals to understand that TIAs associated with even brief periods of ischemia (symptoms) can cause permanent brain injury.
“If you have had symptoms of a TIA, you are at increased risk of a stroke.
“Anyone with a new symptom that may be suggestive of a TIA needs urgent evaluation and treatment, since immediate intervention may substantially reduce the risk of a significant debilitating stroke.”
If you had a TIA but don’t get treatment, and then exercise or physically exert yourself (heavy yard work, roughhousing with grandkids, taking out garbage, etc.), the blood pressure increase from the physical activity can outright cause a stroke — not necessarily another TIA, but a full-blown stroke.
But does this mean that exercise is permanently off-limits to a person who had a transient ischemic attack?
“Exercise at a moderate level of intensity is beneficial to individuals who have had a TIA once the patient has been treated and cleared by their physician to begin an exercise program,” says Dr. Caulin-Glaser.
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“It is important to remember, if a patient has cerebral vascular disease they are at higher risk for also having coronary artery disease, and therefore beginning an exercise program should be initiated only after physician assessment and approval.”
What about people, who were already regularly exercising, prior to the TIA?
Dr. Caulin-Glaser explains, “The individuals still have newly diagnosed vascular disease, and as such should have a stress test with an exercise prescription stating the appropriate heart rate ranges for exercise.
“The stress test will confirm their blood pressure and heart rate responses to maximal exercise are appropriate on the new medications.”
Must people with a TIA history permanently par back on exercise intensity, even if their blood pressure is under control?
Dr. Caulin-Glaser says, “It may not be necessary to par back; the stress test will help make the determination on what is the appropriate level of exercise for each individual.
“Increasing awareness and education regarding the safe approach to a great exercise program is not a limitation, but an endorsement for them to continue lifelong exercise.”
Dr. Caulin-Glaser is an experienced physician, teacher and researcher in the specialty of cardiovascular disease, and formerly the system vice president for Heart & Vascular Services at OhioHealth.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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