Transcript
Okay, another question here reads:
"Good evening, Doc. A few years back, I had a massive heart attack, lots of CPR, and a few rounds with the defibrillator. Fast forward, and I’m healthy, active, and back at my job as a biomedical tech. My long-term memory is as good as it ever was. Short-term memory is better now, but still poor. For example, I just went to a training and found the class extremely hard to follow. After some repetition and relying on general knowledge, I can do routine service. But for repairs, I need assistance. Multitasking is more difficult now, as is learning. I have to be cautious about where I park my car so I don't lose it. A recent MRI showed no damage, and the SLUMS test showed average for my age. But if you separate the long-term from the short-term questions, you see that all the wrong answers were related to short-term memory. Would a neuropsychological test be a good next step?"
Good question. When you have a heart attack, you might not immediately think about cognitive issues, but it's actually not uncommon. A heart attack often involves a loss of blood flow and oxygen to the brain. Depending on how long that lasts, it can cause what's called an anoxic injury—essentially, cell death in certain areas of the brain due to lack of oxygen.
The effects of this type of injury can vary a lot depending on what regions of the brain were impacted, how long someone was without oxygen, and how extensive the injury was. You mentioned this happened a few years ago, and typically, with any sort of brain insult—whether it's a stroke, brain injury, or anoxic injury—you see the most dramatic recovery in the first year. That’s when the brain is doing the most healing. After a year, recovery usually slows down. It’s not like you just hit a wall, but progress tends to level off gradually. Factors like effort, access to resources, and rehabilitation all influence how much more improvement is possible over time.
In your case, it sounds like there's been a major bounce back. Your long-term memory is intact—so things you learned in the past are still accessible. The short-term memory difficulties you're describing, like forgetting where you parked, are good examples of issues with more immediate recall. That’s a common challenge with certain types of brain injury.
You mentioned an MRI, which showed no damage. That’s a good sign—it means no major atrophy, no signs of bleeding, no tumors, no structural abnormalities. An MRI can show things like shrinkage in brain areas, which could suggest a degenerative disease like Alzheimer’s, or other issues like vessel damage or lesions. But none of that is showing up for you, which is excellent.
You also brought up the SLUMS test. I agree—terrible name. It stands for the St. Louis University Mental Status exam. It’s essentially a basic screening tool, like the MoCA or MMSE, that looks at things like orientation, short-term memory, and basic mental functions. But it’s limited in scope—just a quick look at your general cognitive status.
So, would a neuropsychological assessment be a good next step? Absolutely. It would provide much more detailed information than a screening test. You’d be tested on your long-term memory, short-term memory (both verbal and visual), attention, executive functioning (like planning, organizing, and multitasking), and more. You might also learn whether any weaknesses are more related to one side of the brain than the other, which can be helpful diagnostically.
For someone who’s had a serious cardiac event and is noticing real cognitive changes, it’s completely reasonable to request this type of evaluation. And even if your scores all fall within normal limits, that still gives us a baseline. If you’re struggling functionally in your everyday life, the evaluation can help identify practical ways to adapt. You’re the expert on your experience, and it’s about finding ways to make your day-to-day functioning easier and more reliable.
One of the most important parts of the process, at least in how I do it, is the feedback session—where we go over the results and talk about recommendations. That might include cognitive training apps, memory strategies, speech therapy, or just practical tools to help you work around inefficiencies.
It also serves as a baseline for the future. If you ever feel like you’re declining or want to reassess later, you can compare to your previous data and get a clearer picture of what’s happening.
To get started, I recommend asking your doctor for a referral. If you’re seeing a neurologist, they’re a great place to start. Otherwise, you may want to consult both a neurologist and a neuropsychologist to cover both the medical and cognitive sides of things.
Definitely pursue it—and feel free to update me on how it goes.
