Carotid heart disease

• Article
• 2021-02-01

Carotid artery disease is a disease in which a waxy substance called plaque builds up in the carotid arteries. You have two common carotid arteries, one on each side of your neck. They each divide into internal and external carotid arteries.

The internal carotid arteries supply oxygenated blood to your brain. The external carotid arteries supply oxygenated blood to your face, scalp and neck.

CAROTIS ARTICLES

Carotid artery disease is serious because it can cause a stroke, also called a 'brain attack'. A stroke occurs when blood flow to your brain is interrupted.

If the blood flow is interrupted for more than a few minutes, the cells in your brain start to die. This harms the parts of the body that control brain cells. A stroke can cause permanent brain damage; long-term disability, such as vision or speech problems or paralysis (inability to move); or death.

Overview

Carotid artery disease is a leading cause of stroke in the United States. Over time, plaque hardens and narrows the arteries. This can limit the flow of oxygenated blood to your organs and other parts of your body.

Atherosclerosis can affect any artery in the body. For example, if plaque builds up in the coronary arteries (heart), a heart attack can occur. If plaque builds up in the carotid arteries, a stroke can occur.

Stroke can also occur if blood clots form in the carotid arteries. This can happen if the plaque in an artery bursts or tears. Blood cell fragments, called platelets (PLATE-lets), attach to the site of injury and can clump together to form blood clots. Blood clots can partially or completely block a carotid artery.

A piece of plaque or a blood clot can also come off the wall of the carotid artery. The plaque or clot can travel through the bloodstream and become trapped in one of the brain's smaller arteries. This can block blood flow in the artery and cause a stroke.

Carotid artery disease cannot cause signs or symptoms until the carotid arteries are severely narrowed or blocked. For some people, a stroke is the first sign of the disease.

Symptoms

Carotid artery disease cannot cause signs or symptoms until it severely narrows or blocks a carotid artery. Signs and symptoms may include fetus, transient ischemic attack (TIA), or stroke.

Bruit

During a physical exam, your doctor can listen to your carotid arteries with a stethoscope. He or she may hear a whooshing sound called a bruit. This noise may indicate altered or reduced blood flow due to plaque build-up. For more information, your doctor may recommend tests.

Not all people with carotid artery disease have bruises.

Transient ischemic attack (mini stroke)

For some people, having a transient ischemic attack (TIA), or "mini-stroke," is the first sign of carotid artery disease. During a mini-stroke, you can have some or all of the symptoms of a stroke. However, the symptoms usually disappear on their own within 24 hours.

Stroke and mini-stroke symptoms can include:

• A sudden, severe headache with no known cause
• Dizziness or loss of balance
• Inability to move one or more of your limbs
• Sudden trouble seeing in one or both eyes
• Sudden weakness or numbness in the face or limbs, often on only one side of the body
• Problems speaking or understanding speech

Call 9–1–1 for emergency help , even if symptoms stop quickly. Do not drive yourself to the hospital. It is important to get checked and to start treatment as soon as possible.

A mini stroke is a warning sign that you are at high risk of having a stroke. You shouldn't ignore these symptoms. Seeking medical care can help identify possible causes of a minor stroke and help you manage risk factors. These actions can prevent future stroke.

While a mini stroke can warn of a stroke, it does not predict when a stroke will occur. A stroke can occur days, weeks, or even months after a mini-stroke.

Stroke

The symptoms of a strokerte are the same as those of a mini-stroke, but the results are not. A stroke can cause permanent brain damage; long-term disability, such as vision or speech problems or paralysis (inability to move); or death. Most people with strokes have never had warning mini strokes before.

Getting treatment for a stroke right away is very important. You have the best chance of a full recovery if treatment to open a blocked artery is given within 4 hours of the onset of symptoms. The sooner the treatment takes place, the better your chances of recovery.

Call 9–1–1 for emergency assistance as soon as symptoms appear . Do not drive yourself to the hospital. It is very important to be monitored and to start treatment as soon as possible.

Inform those close to you about the symptoms of a stroke and the need for immediate action. By learning the signs and symptoms of a stroke, you can help yourself or someone close to you to reduce the risk of brain damage or death from a stroke.

Therapy

Treatments for carotid artery disease can include heart-healthy lifestyle changes, medications, and medical procedures. The goal of treatment is to keep the disease from getting worse and to prevent stroke. Your treatment will depend on your symptoms, how severe the disease is, and your age and overall health.

Changes in the heart-healthy lifestyle

Your doctor may recommend heart-healthy lifestyle changes if you have carotid artery disease. Changes to your heart-healthy lifestyle include:

• Heart-healthy eating
• Strive for a healthy weight
• Deal with stress
• Fysical activity
• Quit smoking

Medicines

If you have a stroke caused by a blood clot, you may be given a clot-dissolving or clot-lowering medicine. This type of medication must be given within 4 hours of the onset of symptoms. The sooner the treatment takes place, the better your chances of recovery. If you think you are having a stroke, call 9–1–1 immediately for first aid.

Medicines to prevent blood clots are the main treatment for people with carotid artery disease. They prevent platelets from clumping and clotting in your carotid arteries, which can lead to a stroke. Two common drugs are:

• Aspirin
• Clopidogrel

Sometimes lifestyle changes alone are not enough to control your cholesterol levels. For example, you may also need statin medicines to control or lower your cholesterol. By lowering cholesterol in your blood, you can reduce your risk of a heart attack or stroke. Doctors usually prescribe statins for people who:

• Diabetes mellitus
• Have had heart disease or a stroke
• High LDL cholesterol levels

Doctors may discuss starting statin treatment with people who are at increased risk of developing heart disease or having a stroke.

You may need other medications to treat diseases and conditions that damage the carotid arteries. Your doctor may also prescribe medications to:

• Lower your blood pressure.
• Lower your blood sugar.
• Prevent blood clots from forming, which can lead to a stroke.
• Prevent or reduce inflammation.

Use all medications regularly, as directed by your doctor. Do not change the amount of your medicine or skip a dose unless your doctor tells you to. Your healthcare team will help you find a treatment plan that is right for you.

Medical procedures

You may need a medical procedure if you have symptoms caused by a narrowing of the carotid artery. Doctors use one of two methods to open narrowed or blocked carotid arteries: carotid endarterectomy and carotid angioplasty and stent placement.

Carotid endarterectomy

Carotid endarterectomy is primarily for people whose carotid arteries are 50 percent or more blocked.

Before the procedure, a surgeon will make a cut on your neck to reach the narrowed or blocked carotid artery. He or she then makes a cut in the blocked part of the artery and removes the inner b

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