Carotid Artery Disease

What is carotid artery disease?

The carotid arteries are the main blood vessels that carry blood and oxygen to the brain. When these arteries become narrowed, it’s called carotid artery disease. It may also be called carotid artery stenosis. The narrowing is caused by atherosclerosis. This is the buildup of fatty substances, calcium, and other waste products inside the artery lining. Carotid artery disease is similar to coronary artery disease, in which buildup occurs in the arteries of the heart and can cause a heart attack.

Carotid artery disease reduces the flow of oxygen to the brain. The brain needs a constant supply of oxygen to work. Even a brief pause in blood supply can cause problems. Brain cells start to die after just a few minutes without blood or oxygen. If the narrowing of the carotid arteries becomes severe enough that blood flow is blocked, it can cause a stroke. If a piece of plaque breaks off it can also block blood flow to the brain. This too can cause a stroke.

What causes carotid artery disease?

Atherosclerosis causes most carotid artery disease. In this condition, fatty deposits build up along the inner layer of the arteries forming plaque. The thickening narrows the arteries and decreases blood flow or completely blocks the flow of blood to the brain.

Who is at risk for carotid artery disease?

Risk factors associated with atherosclerosis include:

  • Older age
  • Male
  • Family history
  • Race
  • Genetic factors
  • High cholesterol
  • High blood pressure
  • Smoking
  • Diabetes
  • Overweight
  • Diet high in saturated fat
  • Lack of exercise

Although these factors increase a
person’s risk, they don’t always cause the disease. Knowing your risk factors can help
you make lifestyle changes and work with your healthcare provider to reduce chances you
will get the disease.

What are the symptoms of carotid artery disease?

Carotid artery disease may have no symptoms. Sometimes, the first sign of the disease is a transient ischemic attack (TIA) or stroke.

A transient ischemic attack (TIA)
is a sudden, temporary loss of blood flow to an area of the brain. It usually lasts a
few minutes to an hour. Symptoms go away entirely within 24 hours, with complete
recovery. When symptoms continue, it is a stroke. Symptoms of a TIA or stroke may
include:

  • Sudden weakness or clumsiness of an arm or leg on one side of the body
  • Sudden paralysis of an arm or leg on one side of the body
  • Loss of coordination or movement
  • Confusion, decreased ability to concentrate, dizziness, fainting, or headache
  • Numbness or loss of feeling in the face or in an arm or leg
  • Temporary loss of vision or blurred vision
  • Inability to speak clearly or slurred speech

If you or a loved one has any of
these symptoms, call for medical help right away. A TIA may be a warning sign that a
stroke is about to occur. But TIAs don’t precede all strokes.

The symptoms of a TIA and stroke
are the same. A stroke is loss of blood flow (ischemia) to the brain that continues long
enough to cause permanent brain damage. Brain cells start to die after just a few
minutes without oxygen.

The disability that occurs from
stroke depends on the size and location of the area of the brain that suffered loss of
blood flow. This may include problems with:

  • Moving
  • Speaking
  • Thinking
  • Remembering
  • Bowel and bladder function
  • Eating
  • Emotional control
  • Other vital body functions

Recovery also depends on the size and location of the stroke. A stroke may result in long-term problems, such as weakness in an arm or leg. It may cause paralysis, loss of speech, or even death.

The symptoms of carotid artery
disease may look like other health conditions or problems. Always see your healthcare
provider for a diagnosis.

How is carotid artery disease diagnosed?

Your healthcare provider will ask
about your health history and do a physical exam. You will also need tests for carotid
artery disease. These may include:

  • Listening to the carotid arteries.
    For this test, your healthcare provider places a stethoscope over the carotid
    artery to listen for a sound called a bruit (BREW-ee). This sound is made when blood
    passes through a narrowed artery. A bruit can be a sign of atherosclerosis. But an
    artery may be diseased without making this sound.
  • Carotid artery duplex scan. This test
    is done to assess the blood flow of the carotid arteries. A probe called a transducer
    sends out ultrasonic sound waves. The transducer is like a microphone. When the
    transducer is placed on the carotid arteries at certain locations and angles, the
    sound waves move through the skin and other body tissues to the blood vessels, where
    the waves echo off of the blood cells. The transducer sends the waves to an
    amplifier, so the provider can hear the sound waves. Absence of or faintness of these
    sounds may mean blood flow is blocked.
  • MRI. This procedure uses a
    combination of large magnets, radio waves, and a computer to make detailed images of
    organs and structures in the body. For this test, you lie inside a big tube while
    magnets pass around your body. It’s very loud. 
  • MR angiography (MRA). This procedure
    uses MRI technology and IV contrast dye to make the blood vessels visible. Contrast
    dye causes blood vessels to appear solid on the MRI image so the doctor can see
    them.
  • CT angiography (CTA). This test uses
    X-rays and computer technology along with contrast dye to make detailed images  of
    the body. A CTA shows pictures of blood vessels and tissues and is helpful in finding
    narrowed blood vessels.  
  • Angiography. This test is used to
    assess the how blocked the carotid arteries are by taking X-ray images while a
    contrast dye is injected. The contrast dye helps the healthcare provider see the
    shape and flow of blood through the arteries as X-ray images are made.