Critical Information – Know the Symptoms of a Stroke

Ambulance driving on a paved road with lights flashing

Every minute counts during a stroke, with nearly two million brain cells dying every sixty seconds, yet fewer than half of Americans know all the warning signs or the critical importance of calling 911 immediately.

At a Glance

  • Awareness of stroke symptoms has improved, with recognition increasing from 76.1% to 93.7% between 2009 and 2014
  • The F.A.S.T. acronym (Face, Arm, Speech, Time) is more effective than BE-FAST for helping people remember key stroke warning signs
  • About 800,000 Americans suffer strokes annually, with up to 80% potentially preventable through lifestyle changes
  • Calling 911 immediately activates a specialized emergency response that can begin treatment before hospital arrival
  • On average, 1.9 million brain cells die every minute a stroke goes untreated, making swift action crucial

Understanding Stroke Symptoms Can Save Lives

Stroke remains the fifth leading cause of death in the United States and a major contributor to long-term disability. Recognizing the warning signs quickly can mean the difference between recovery and permanent brain damage. A study published in the National Health Interview Survey tracked significant improvements in stroke awareness among U.S. adults between 2009 and 2014, with knowledge of symptoms increasing by 14.7 percentage points during that period. By 2014, recognition of specific symptoms varied from 76.1% for sudden severe headache to 93.7% for numbness of the face, arm, leg, or side.

“It is critically important that there is a recognition of stroke signs and symptoms by the general public. The more people are aware of the stroke warning signs, the better we may activate the processes needed to ensure patients get care as quickly as possible,” says Opeolu Adeoye, M.D., M.S., FAHA.

Women face a higher stroke risk, with one in five women between ages 55-75 experiencing a stroke. While symptoms are generally similar for both sexes, women might also experience general weakness, disorientation, fatigue, nausea, or vomiting. Some stroke symptoms remain less recognized, including generalized weakness, fatigue, or lethargy, which can be mistakenly attributed to other conditions, particularly in older adults.

F.A.S.T Is More Effective Than BE-FAST

To help people remember stroke symptoms, health organizations have created acronyms. Research shows the F.A.S.T. approach (Face drooping, Arm weakness, Speech difficulty, Time to call 911) is more effective than the expanded BE-FAST version, which adds Balance and Eyes to the list. While the expanded version is more comprehensive, the four-letter acronym proved easier for people to recall when needed. Both acronyms effectively motivated people to call 911 when stroke symptoms appeared, with the impact lasting for at least 30 days after exposure to the messaging.

“Historically, health care professionals want to provide the most comprehensive warning sign mnemonic to ensure no strokes are missed. What this research shows is, from a public point of view, adding two extra letters made it more challenging to recall the stroke warning signs,” explains Opeolu Adeoye, M.D., M.S., FAHA.

There are three main types of strokes that people should be aware of: ischemic strokes (caused by blood clots blocking vessels to the brain), hemorrhagic strokes (caused by bleeding in the brain), and transient ischemic attacks (TIAs or “mini-strokes”). TIAs serve as warning signs with symptoms similar to full strokes but lasting only a short time. Even these temporary episodes warrant immediate medical attention, as they often precede a more severe stroke.

Why Calling 911 Is Critical

When stroke symptoms appear, calling 911 immediately rather than driving to the hospital or waiting to see if symptoms improve can be lifesaving. Emergency medical services can begin treatment en route to the hospital and notify the emergency department to prepare specialized stroke care before the patient arrives. This rapid response can significantly improve outcomes, as effective treatments often must be administered within a specific time window after symptoms begin.

“The sooner someone calls 911, the faster the process can start,” says Monica Emde, an emergency medical services expert. “The faster you call 911 and get to the hospital, the more likely you are to have a successful and full recovery.”

Financial concerns should never prevent someone from calling 911 during a potential stroke. Federal laws ensure emergency treatment regardless of insurance status, and the Affordable Care Act requires most health plans to cover emergency services. The cost of delayed treatment—permanent disability or death—far outweighs any financial considerations. If there’s any doubt about whether symptoms indicate a stroke, medical experts unanimously recommend erring on the side of caution and calling 911.

Prevention Remains The Best Strategy

While recognizing symptoms and taking swift action are crucial, preventing strokes altogether is even better. Up to 80% of strokes may be preventable through lifestyle modifications including regular exercise, maintaining a healthy diet, not smoking, limiting alcohol consumption, and managing conditions like high blood pressure, diabetes, and high cholesterol. Regular medical check-ups can help identify and address these risk factors before they lead to a stroke.

“Stroke is a leading cause of disability and death, but it doesn’t have to be,” states Joshua Marcus, MD. “Listen, a stroke is no joke.”

With approximately 800,000 Americans suffering strokes annually and stroke remaining the fifth leading cause of death in the United States, continued public education about recognizing symptoms and taking immediate action by calling 911 remains essential to reducing stroke’s devastating impact. Additional resources and support are available through organizations like the American Heart Association and their Stroke Family Warmline for those seeking more information about stroke prevention, recognition, and recovery.

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