Carotid Arteries: Causes, Symptoms, Diagnosis, Treatment, and Prevention
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.
Causes of Carotid Artery Disease
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:
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High blood pressure, which puts extra strain on the artery walls and damages them
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High cholesterol, which increases the amount of plaque formation
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Smoking, which irritates the inner lining of the arteries and makes them more prone to plaque buildup
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Diabetes, which affects the ability to process fats and sugars and increases the risk of plaque formation
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Obesity, which is associated with higher blood pressure, cholesterol, and diabetes
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Sedentary lifestyle, which reduces the blood circulation and increases the risk of plaque formation
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Family history of carotid artery disease or other types of heart disease, which may indicate a genetic predisposition
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Age, which weakens the arteries and makes them more susceptible to plaque buildup
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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.
Symptoms of Carotid Artery Disease
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:
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Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body
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Sudden trouble speaking or understanding speech
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Sudden trouble seeing in one or both eyes
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Sudden dizziness, loss of balance, or difficulty walking
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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.
Diagnosis of Carotid Artery Disease
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:
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Blood tests, which can measure your cholesterol, blood sugar, and other markers of heart health
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Carotid ultrasound, which uses sound waves to create images of the carotid arteries and measure the blood flow and the degree of narrowing
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Carotid angiogram, which involves injecting a dye into the carotid arteries and taking X-rays to show the location and extent of the blockage
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Magnetic resonance angiogram (MRA), which uses magnetic fields and radio waves to produce detailed images of the carotid arteries and the brain
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Computed tomography angiogram (CTA), which uses X-rays and a computer to create cross-sectional images of the carotid arteries and the brain
Treatment of Carotid Artery Disease
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:
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Lifestyle changes, such as quitting smoking, eating a healthy diet, exercising regularly, maintaining a healthy weight, and managing stress
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Medications, such as antiplatelets, anticoagulants, statins, and blood pressure drugs, which can prevent blood clots, lower cholesterol, and improve blood flow
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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.
Prevention of Carotid Artery Disease
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:
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Monitor and control your blood pressure
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Monitor and control your blood sugar if you have diabetes
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Monitor and control your cholesterol levels
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Quit smoking or avoid exposure to secondhand smoke
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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
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Exercise regularly for at least 150 minutes per week, or as recommended by your doctor
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Maintain a healthy weight or lose weight if you are overweight or obese
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Manage stress and practice relaxation techniques
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Limit alcohol consumption to no more than one drink per day for women and two drinks per day for men
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Follow your doctor’s advice and take your medications as prescribed
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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.
