Symptom awareness and a new fast-acting drug saved this Mount Sinai patient’s life.
Recognizing the early signs of a stroke can be lifesaving—they require immediate action, and knowing what to look for is crucial. For Carlos Molina, a 66-year-old retiree, his quick response to strange symptoms made all the difference.
One night, Carlos felt his right arm go numb and recalled experiencing weakness in his hands earlier in the day. Sensing something was wrong, his wife rushed him to Mount Sinai Medical Center’s ER in Hialeah, where medical staff confirmed he was having a stroke. He recalls the swift and professional care he received: “The moment we arrived at the hospital, everything moved quickly. Everyone was very professional and caring,” Carlos says. “I don’t know exactly what they did, but within an hour, I felt like I regained consciousness.” He was later transferred to Mount Sinai’s Miami Beach campus, where he spent a week under observation.
There, he was under the care of Dr. Vasu Saini, a Neuro Endovascular Surgeon at Mount Sinai, who diagnosed Carlos with severe ulcerated atherosclerotic stenosis in his neck—a condition where cholesterol buildup led to a clot, causing the stroke. He successfully underwent a stent-assisted angioplasty of the carotid and was discharged with no neurological deficit. During his treatment at the Hialeah ER, Dr. Saini noted that the team administered tenecteplase, a clot-dissolving medication that helped break up the embolism in Carlos’ brain. “He came to us within 30 minutes and got the tenecteplase fairly quickly,” Dr. Saini explains. “The medication dissolved the clot, and his symptoms improved.”
Recently approved for use at Mount Sinai, tenecteplase is a faster acting, targeted treatment than the previously used alteplase. It’s administered as a single, five-second IV, simplifying the process and improving recovery chances when time is critical. “We switched from alteplase to tenecteplase because it specifically targets the clot and requires only one quick bolus injection, whereas alteplase needs an IV infusion over 60 minutes,” Dr. Saini explains. This thrombolytic drug is available at all Mount Sinai ERs, ensuring patients can receive it during an ischemic stroke before being transferred to the main campus for continued care.
Dr. Saini underscores the importance of recognizing stroke symptoms early, as treatment is most effective when started close to the event. Symptoms of a stroke may include sudden weakness or numbness in any part of the body, difficulty speaking or understanding, dizziness or vertigo, or vision problems. Many patients don’t realize that delaying action when experiencing these symptoms leads to irreversible brain injury. “Even though our treatment paradigms have changed so that we can treat patients over a 24-hour period, the most important thing to stress is the earlier the patient gets to the hospital, the better the outcome,” Dr. Saini explains. “Just because we can treat someone within 24 hours [of a stroke] doesn’t mean they have a 24-hour window.”
Carlos is now doing well after further treatment at the Miami Beach campus and has been back for follow-ups with Dr. Saini, who is monitoring him closely. He credits Mount Sinai for their swiftness and compassion during his admission to the hospital. And, based off Carlos’ experience, Dr. Saini continues to emphasize that recognizing early signs is pivotal for timely and effective treatment.
When experiencing symptoms of a stroke, use the mnemonic device FAST-ED to identify early signs:
- F: Facial drooping
- A: Arm weakness
- S: Speech difficulties
- T: Time to call 911
- E: Eye deviation
- D: Denial/neglect (where a patient fails to recognize their non-dominant arm as weak or as their own)
To learn more about Mount Sinai’s Harvey R. Chaplin Family Stroke & Chest Pain Center, please click HERE.
