Stroke: think FAST
A stroke happens when blood supply to part of the brain is blocked, or a blood vessel in the brain bleeds. Brain cells begin to die within minutes, so fast treatment saves brain function and lives.
| Letter | Sign | Check |
|---|---|---|
| Face | Drooping on one side | Ask the person to smile. Is it uneven? |
| Arm | Weakness or numbness | Ask them to raise both arms. Does one drift down? |
| Speech | Slurred, strange or absent | Ask them to repeat a simple sentence |
| Time | Act now | Call 10177 or 112 and note the time symptoms started |
Other sudden signs of stroke include:
- loss of balance or coordination;
- sudden loss of vision in one or both eyes, or double vision;
- sudden confusion;
- a sudden, severe headache unlike any before.
Some people use BE FAST, adding Balance and Eyes to the checklist.
Even if symptoms go away, get checked urgently. A "mini-stroke" (transient ischaemic attack, or TIA) is a warning that a major stroke may follow.
Heart attack: know the signs
A heart attack happens when blood flow to part of the heart muscle is blocked.
Common symptoms:
- chest pain, pressure, tightness or heaviness, often in the centre of the chest, lasting more than a few minutes or coming and going;
- pain spreading to the arm (especially the left), neck, jaw, back or upper abdomen;
- shortness of breath;
- sweating, feeling clammy;
- nausea or vomiting;
- light-headedness or feeling faint.
Symptoms that are easier to miss: women, older adults and people with diabetes are more likely to have less typical symptoms, such as breathlessness, unusual tiredness, indigestion-like discomfort, nausea, or back or jaw pain, sometimes without obvious chest pain.
What to do
- Call 10177 or 112 immediately. If you belong to a medical scheme, its emergency service can also help.
- Don't drive yourself to hospital.
- Stay with the person. Keep them calm and seated or lying down, whichever is most comfortable.
- Note the time symptoms started. This guides treatment, especially for stroke.
- For suspected stroke, don't give anything to eat or drink, as swallowing may be affected.
- Follow the call-taker's instructions. They may give advice about medicines while you wait.
- If the person collapses and isn't breathing normally, start chest compressions (hands-only CPR): push hard and fast in the centre of the chest, about 100 to 120 times a minute, until help arrives. Use an AED (defibrillator) if one is available.
Why it matters in South Africa
According to the Heart and Stroke Foundation South Africa, stroke is a leading cause of death and disability in the country, and up to 80% of strokes are preventable. Around one in three adults has blood pressure in the high-normal or high range, and about half of these are untreated or not taking treatment as prescribed. HIV is also an important stroke risk factor in South Africa, and strokes here often affect people younger than 50.
Lowering your risk
- Know and control your blood pressure. It is the single biggest risk factor for stroke.
- Check cholesterol and blood sugar, and treat them if needed.
- Don't smoke or vape.
- Move regularly, eat mostly whole foods, and limit salt and alcohol.
- Keep a healthy waist size.
- Know your HIV status, and take treatment consistently if positive.
- Get an irregular heartbeat checked. Atrial fibrillation raises stroke risk and is treatable.
When to see a doctor
Emergency (call 10177 or 112): any of the warning signs above.
Book a check-up if you have high blood pressure, diabetes, high cholesterol, a family history of early heart disease or stroke, an irregular pulse, or chest discomfort when exercising that settles with rest.
Frequently asked questions
Can young people have a stroke or heart attack?
Yes. Although risk rises with age, both can happen to younger adults, particularly with high blood pressure, smoking, diabetes, HIV or a family history.
What if I'm not sure it's serious?
Call for help anyway. It's much better to be checked and reassured than to delay treatment.
Can anxiety cause chest pain?
Yes, but new or unexplained chest pain should always be treated as a possible emergency until a doctor has checked it.
Should I take an aspirin?
Only if the emergency call-taker or a doctor advises it. Aspirin isn't right for everyone, and it isn't used for suspected stroke until a scan shows the type.
References
- Heart and Stroke Foundation South Africa. World Stroke Awareness Week press release. 2025. https://heartfoundation.co.za/wp-content/uploads/2025/10/WSW25-Press-Release-1.pdf
- Heart and Stroke Foundation South Africa. https://www.heartfoundation.co.za
- Resuscitation Council of Southern Africa. Adult basic life support guidelines.
This article is for general educational purposes only, like a health newsletter. It is not medical advice, diagnosis or treatment, and reading it does not create a doctor and patient relationship. Please speak to your own doctor about your situation. In an emergency, call 10177 or 112, or go to your nearest emergency unit.