Description

Carotid artery disease occurs when fatty deposits called plaques clog the blood vessels that supply blood to the brain and head (carotid arteries). The blockage increases your risk of stroke. Stroke is a medical emergency that occurs when the brain loses the whole or a large part of its blood supply.

During a stroke, the brain does not receive oxygen and the brain cells begin to die in a matter of minutes. Stroke is one of the leading causes of death and disability in the united states

Carotid artery disease often develops slowly. The first sign of the disease could be a stroke or transient ischemic attack (TIA). A TIA is a temporary shortage of blood flow to the brain.

The treatment of carotid artery disease usually involves lifestyle changes, medications, and sometimes surgery.

Symptoms

In its early stages, carotid artery disease often has no symptoms. The condition may not become apparent until it is sufficiently serious as to deprive the brain of blood, causing a stroke or TIA .

The symptoms of a stroke or TIA include:

  • Sudden numbness or weakness in the face or limbs, often on one side of the body.
  • Sudden difficulty speaking and understanding the language.
  • Sudden trouble seeing in one or both eyes.
  • Sudden dizziness or loss of balance.
  • Sudden, severe headache with no known cause.

When to see a doctor

Seek emergency care for any of the symptoms of a stroke. Even if you only last a short time and then you feel well, consult a health care provider immediately. You may have had a TIA . A TIA puts you at risk of a stroke.

Talk with your health care provider if you have risk factors for carotid artery disease, even if you have no symptoms. The management of risk factors can protect from a blow. To see a provider early increases your chances of finding carotid artery disease and get treatment before a stroke occurs.

Causes

A buildup of fatty deposits, known as plaques in the arteries that carry blood to the brain that cause disease of the carotid artery. The plaques are aggregates that include the cholesterol, the fat and the blood cells that form in the arteries. This process is called atherosclerosis.

The carotid arteries, which are covered with plates close. A blockage in carotid arteries, makes it difficult for oxygen and nutrients to the brain.

Risk factors

The factors that increase the risk of carotid artery disease are:

  • The high blood pressure. Too much pressure on the walls of the arteries can weaken them and make them more easy to damage.
  • The consumption of tobacco. Nicotine can irritate the inner lining of the arteries. Smoking also increases the heart rate and blood pressure.
  • Diabetes. Diabetes reduces the ability to process fats, creating a greater risk of high blood pressure and atherosclerosis.
  • High blood-fat levels. High levels of low-density lipoprotein cholesterol and high levels of triglycerides, a type of fat in the blood, it helps the build up of plaques.
  • The history of the family. The risk of carotid artery disease is higher if a family member has atherosclerosis or coronary artery disease.
  • Age. The arteries become less flexible and more likely to be injured with age.
  • Obesity. Excess weight increases the chances of hypertension, atherosclerosis and diabetes.
  • Sleep apnea. The periods of cessation of breathing during the night may increase the risk of stroke.
  • The lack of exercise. Lack of exercise leads to conditions that can damage the arteries, including high blood pressure, diabetes, and obesity.

Complications

Carotid artery disease causes approximately 10% to 15% of strokes. A stroke is a medical emergency that can lead to brain damage, muscle weakness, and possibly death.

Carotid artery disease can lead to stroke through:

  • The reduction in blood flow. A carotid artery can be as narrow as a consequence of atherosclerosis that not enough blood reaches parts of the brain.
  • The rupture of the plates. A piece of plaque can break off and travel to the smaller arteries in the brain. The piece of plaque can become trapped in one of these smaller arteries. This lock is cut off the blood supply to part of the brain.
  • Blood clot blocking. Some plates are prone to cracking and the formation of irregular surfaces in the wall of the artery. The body reacts as it does to an injury. Sends the blood cells that help the clotting process of the area. The result can be a large blood clot that blocks or slows the flow of blood to the brain, causing a stroke.

Prevention

These steps can help prevent carotid artery disease or prevent it from getting worse:

  • Do not smoke. Within a few years of quitting smoking, a former smoker's risk of stroke is like a person who has never smoked.
  • Maintain a healthy weight. Being overweight increases other risk factors, like high blood pressure, cardiovascular disease, diabetes, and sleep apnea.
  • Eat a healthy diet. Focus on fruits and vegetables, whole grains and fish, nuts and legumes. Limit the amount of cholesterol and fat, especially saturated fats and trans fats.
  • Limit salt. The excess salt can increase blood pressure in some people. Experts recommend that healthy adults consume less than 1,500 milligrams of salt per day.
  • Exercise regularly. The exercise can decrease blood pressure, increase high-density lipoprotein (HDL) cholesterol, the "good" cholesterol — and improve the overall health of your blood vessels and the heart. It also helps you lose weight, control diabetes and reduce stress.
  • Limit or avoid the consumption of alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.
  • Control of diseases. Management of conditions such as diabetes and high blood pressure, help to protect the arteries.

Diagnosis

The diagnosis usually begins with a medical history and physical examination. The exam generally includes listening for a vibration of sound, known as a bruit over the carotid artery in the neck. A narrowed artery makes the sound. The next step could be a test of the physical and mental ability, such as strength, memory and speech.

Imaging tests

These may include:

  • Ultrasound. This is seen in the blood flow and pressure in the carotid arteries.
  • CTorMRI. These can indicate if there has been a stroke, or other problems.
  • CTangiography orMRangiography. These give more information about the blood flow in the carotid arteries. These scans, the images of the neck and brain after a contrast dye is inserted into a blood vessel. The dye makes the areas of the images stand out.

Treatment

The goal in the treatment of carotid artery disease is to prevent a stroke. The treatment depends on how blocked the carotid arteries are, if the blockage is causing the symptoms, age and other diseases of the person who has the lock.

The treatment of mild to moderate obstruction can include:

  • Lifestyle changes to delay the accumulation of fatty deposits. These may include quitting smoking, losing weight, eating healthy foods, reducing salt, and exercising regularly.
  • Medications to control blood pressure or cholesterol. This might include taking a daily aspirin or other blood thinners to prevent the formation of blood clots.

For the severe blockage or for people who have suffered a TIA or stroke, the treatment may involve the removal of the obstruction. The options include:

  • Carotid endarterectomy. This is the most common treatment for severe carotid artery disease. After cutting along the front of the neck, a surgeon opens the blockage of the carotid artery and removes the plaques. The surgeon uses stitches or a graft for the repair of the artery.
  • Carotid angioplasty with stenting.This treatment is for the locks too difficult to reach with carotid endarterectomy or for people who have other health conditions that make surgery too risky. This involves a local anesthetic, known as the anesthesia. A surgeon uses a tube called a catheter, to send a small globe in the area of the obstruction. The surgeon inflates the balloon to widen the artery. The surgeon then placed in a small wire mesh coil, known as a stent to keep the artery from narrowing again.

Carotid angioplasty with stenting. This treatment is for the locks too difficult to reach with carotid endarterectomy or for people who have other health conditions that make surgery too risky. This involves a local anesthetic, known as the anesthesia.

A surgeon uses a tube called a catheter, to send a small globe in the area of the obstruction. The surgeon inflates the balloon to widen the artery. The surgeon then placed in a small wire mesh coil, known as a stent to keep the artery from narrowing again.

Preparing for your appointment

Your primary care physician may refer you to a doctor who specializes in conditions of the nervous system and the brain, known as a neurologist.

What you can do

Ask a friend or family member go with you to your appointment to help you remember all the information that you get.

Make a list of:

  • Their symptoms, and when they began.
  • All the drugs, vitamins, and supplements you are taking, including dosage.
  • Key medical information, including other conditions you have and the family history of heart attack and stroke.
  • Questions to ask your health care provider.

Questions to ask your doctor

  • What is the most likely cause of my symptoms?
  • What tests do I need?
  • What treatments do I need?
  • What lifestyle changes I need to do?

Ask all the questions that you have.

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

  • Have you had any stroke-like signs and symptoms, such as weakness on one side of the body, difficulty speaking, or sudden vision problems?
  • Do you smoke?
  • How much alcohol do you drink?
  • Do you exercise regularly?
  • What do you eat in a typical day?
  • Do you have symptoms of sleep apnea?
Symptoms and treatment of Carotid artery disease