A carotid artery is a large blood vessel that supplies oxygen-rich blood to the brain and head, and it can be felt in the neck with your pulse. It occurs when fatty deposits, called plaques, narrow or block these arteries, causing carotid artery disease. If there is inadequate blood flow to the brain, the risk of stroke increases. Strokes are serious medical emergencies that happen when the brain does not get enough oxygen.
The main cause of carotid artery disease is atherosclerosis, which is the hardening and narrowing of the arteries due to the buildup of plaques. Plaques are made up of cholesterol, fat, calcium, and other substances that stick to the inner walls of the arteries. As they grow, they can reduce the amount of space available for blood to flow. Blood clots can also form if they rupture, which can block the artery completely.
Some factors that can contribute to the development of atherosclerosis and carotid artery disease are:
High blood pressure, which puts extra strain on the artery walls and damages them
High cholesterol, which increases the amount of plaque formation
Smoking, which irritates the inner lining of the arteries and makes them more prone to plaque buildup
Diabetes, which affects the ability to process fats and sugars and increases the risk of plaque formation
Obesity, which is associated with higher blood pressure, cholesterol, and diabetes
Sedentary lifestyle, which reduces the blood circulation and increases the risk of plaque formation
Family history of carotid artery disease or other types of heart disease, which may indicate a genetic predisposition
Age, which weakens the arteries and makes them more susceptible to plaque buildup
Gender, which affects the risk differently depending on the age group. Men younger than 75 have a higher risk than women in the same age group, while women older than 75 have a higher risk than men in the same age group.
The symptoms of carotid artery disease are usually not apparent until the disease is severe enough to affect the brain's blood flow. A stroke or transient ischemic attack (TIA) can be the first sign of the condition, which is characterized by a temporary loss of blood flow to the brain that usually lasts a few minutes to hours. This type of stroke indicates a high risk of developing a full-blown stroke in the future. It is also called a mini-stroke or a warning stroke.
Some of the symptoms of a stroke or a TIA include:
Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body
Sudden trouble speaking or understanding speech
Sudden trouble seeing in one or both eyes
Sudden dizziness, loss of balance, or difficulty walking
Sudden severe headache with no known cause
If you experience any of these symptoms, you should seek medical attention immediately, as prompt treatment can prevent permanent brain damage and disability.
In order to diagnose carotid artery disease, your doctor will need to know your medical history, risk factors, and symptoms. You will also receive a physical examination, which may include listening to the sound of blood flowing through your carotid arteries with a stethoscope. A bruit is an abnormal sound caused by turbulent blood flow in a narrowed artery.
Your doctor may also order some tests to confirm the diagnosis and assess the severity of the condition. These tests may include:
Blood tests, which can measure your cholesterol, blood sugar, and other markers of heart health
Carotid ultrasound, which uses sound waves to create images of the carotid arteries and measure the blood flow and the degree of narrowing
Carotid angiogram, which involves injecting a dye into the carotid arteries and taking X-rays to show the location and extent of the blockage
Magnetic resonance angiogram (MRA), which uses magnetic fields and radio waves to produce detailed images of the carotid arteries and the brain
Computed tomography angiogram (CTA), which uses X-rays and a computer to create cross-sectional images of the carotid arteries and the brain
Carotid artery disease is treated according to its severity and stroke risk, with the main goals being to reduce the risk of stroke, improve blood flow to the brain, and prevent a stroke.
The treatment options may include:
Lifestyle changes, such as quitting smoking, eating a healthy diet, exercising regularly, maintaining a healthy weight, and managing stress
Medications, such as antiplatelets, anticoagulants, statins, and blood pressure drugs, which can prevent blood clots, lower cholesterol, and improve blood flow
Surgery, such as carotid endarterectomy or carotid stenting, which can remove or bypass the plaque in the carotid artery and restore the blood flow to the brain
In order to remove the plaque from the carotid artery, an incision in the neck is made during carotid endarterectomy. A carotid stenting involves inserting a catheter into the carotid artery and inflating a balloon to widen it. In order to keep the artery open, a small mesh tube called a stent is placed.
Both procedures have benefits and risks, and your doctor will help you decide which one is best for you based on your individual situation.
The best way to prevent carotid artery disease is to reduce the risk factors that can cause atherosclerosis and plaque formation. Some of the preventive measures are:
Monitor and control your blood pressure
Monitor and control your blood sugar if you have diabetes
Monitor and control your cholesterol levels
Quit smoking or avoid exposure to secondhand smoke
Eat a balanced diet that is low in saturated fat, trans fat, salt, and added sugar, and high in fruits, vegetables, whole grains, and lean protein
Exercise regularly for at least 150 minutes per week, or as recommended by your doctor
Maintain a healthy weight or lose weight if you are overweight or obese
Manage stress and practice relaxation techniques
Limit alcohol consumption to no more than one drink per day for women and two drinks per day for men
Follow your doctor’s advice and take your medications as prescribed
Have regular check-ups and screenings for carotid artery disease and other heart conditions
It is never too late to start taking care of your carotid arteries and your brain, and by following these steps you can lower your risk of carotid artery disease and stroke.
