The 30-second heart check that could help prevent a stroke

By Professor Hosen Kiat, cardiologist registered on Doctify

Could a 30-second self-check help prevent a stroke?

In a lifetime as a cardiologist, one conversation has never become easier. It happens after a stroke.

A patient or their family asks, “How could this have happened? There were no warning signs.”

Sometimes that’s true. But far too often, the warning was there. It simply went unnoticed, hidden in the heartbeat.

The condition is called atrial fibrillation, or AF. It is an irregular heart rhythm and a major cause of ischaemic stroke, particularly in older adults. Yet many Australians

have never heard of it, let alone had their heart rhythm checked.

This National Stroke Week, I want to help change that.

What is atrial fibrillation?

The heart normally beats in a steady, coordinated rhythm. In AF, the upper chambers quiver rather than contract effectively. Blood can pool inside the heart, allowing a clot to form. If that clot travels to the brain, it can cause a stroke.

Strokes associated with AF tend to be more severe and carry a higher risk of death than strokes from many other causes.

What makes AF particularly dangerous is that it may cause no symptoms at all.

Some people notice palpitations, breathlessness or unusual fatigue. But many notice nothing.

AF can also come and go. Your rhythm may be perfectly normal during an annual check-up but irregular at other times. A normal ECG on one day does not guarantee

a normal rhythm every day.

Who is most at risk?

Age is the biggest risk factor. AF is relatively uncommon in middle age but becomes increasingly common through the seventies and eighties.

Your risk is also higher if you have high blood pressure, obesity, sleep apnoea, diabetes or heart disease, or drink excessive amounts of alcohol. Some of these factors can be changed, making AF not only detectable but, to some extent, preventable.

What you can do this week

Check your pulse. Sit quietly and place two fingers on the inside of your wrist, below your thumb. Feel your pulse for about 30 seconds. You are not simply counting the

beats; you are checking whether they feel regular. A normal pulse should be steady, like a clock.

If your pulse feels irregular or erratic, arrange an appointment with your GP. This check cannot diagnose AF, but it may identify a rhythm that needs further assessment.

Ask for a heart rhythm check. If you are over 65, speak with your GP about having your pulse or heart rhythm checked, particularly if you have high blood pressure,

diabetes, heart disease or other stroke risk factors. A simple pulse check during a routine consultation may help detect AF earlier.

Treat your smartwatch as an alert, not a diagnosis. Many wearable devices can flag a possible irregular rhythm. They are useful, but they are not perfect. If your watch

sends an alert, do not ignore it, but do not panic either. Show the recording to your doctor and have the rhythm assessed properly.

Know the signs of stroke. Remember F.A.S.T.: Face drooping, Arm weakness, Speech difficulty, Time to call Triple Zero (000). Even if the symptoms disappear,

seek urgent medical attention. A so-called “mini-stroke” may be a warning that a larger stroke is coming.

Before it’s too late

AF-related stroke is especially frustrating because, once AF is identified, blood-thinning medicines can substantially reduce stroke risk in patients who need them. The problem is not that we lack effective treatment. It is that too many people remain undiagnosed.

I understand why people avoid health checks. Nobody likes the possibility of bad news.

But the patients who carry the greatest regret are rarely those whose AF was found early. They are the people who discover it only after a stroke, lying in a hospital bed

and wondering whether anything could have been done.

Too often, the answer is yes.Stroke can seem sudden and unpredictable. But sometimes the risk has been building quietly in the heart for years.

This National Stroke Week, take 30 seconds to check your pulse. Ask your GP about your heart rhythm. Encourage your partner, parents and friends over 65 to do the

same.

It is one of the simplest health checks you can perform. It could also be one of the most important.

Professor Hosen Kiat is an Australian cardiologist registered on Doctify, medical scientist and the founder of TAIK Health with a career spanning clinical care, teaching and research. He is recognised in Stanford University’s global rankings among the top 1% of clinical medicine researchers worldwide and has authored more than 200 peer-reviewed publications, with over 16,000 citations. Dr Kiat’s work focuses on cardiovascular health, preventive medicine and evidence-based integrative approaches. Born in Jakarta and trained at Monash University, Cedars-Sinai and UCLA, he has cared for more than 100,000 patients over his clinical career and was instrumental in establishing Macquarie University’s medical school and on-campus hospital. He is a Fellow of the Royal Australasian College of Physicians, the American College of Cardiology, the Cardiac Society of Australia and New Zealand, the American College of Physicians, the American College of Chest Physicians, the American Society of Nuclear Cardiology and the Australasian Association of Nuclear Medicine Specialists.