- Carotid artery disease
Carotid artery disease is a disease in which a waxy substance called plaque builds up inside 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 oxygen-rich blood to your brain. The external carotid arteries supply oxygen-rich blood to your face, scalp, and neck.
Carotid artery disease is serious because it can cause a stroke, also called a “brain attack.” A stroke occurs if blood flow to your brain is cut off.
If blood flow is cut off for more than a few minutes, the cells in your brain start to die. This impairs the parts of the body that the brain cells control. A stroke can cause lasting brain damage; long-term disability, such as vision or speech problems or paralysis (an inability to move); or death.
- Causes of Carotid Artery Disease
Carotid artery disease seems to start when damage occurs to the inner layers of the carotid arteries. Major factors that contribute to damage include:
• High levels of certain fats and cholesterol in the blood
• High blood pressure
• High levels of sugar in the blood due to insulin resistance or diabetes
When damage occurs, your body starts a healing process. The healing may cause plaque to build up where the arteries are damaged. The plaque in an artery can crack or rupture. If this happens, blood cell fragments called platelets will stick to the site of the injury and may clump together to form blood clots. The buildup of plaque or blood clots can severely narrow or block the carotid arteries. This limits the flow of oxygen-rich blood to your brain, which can cause a stroke.
- Risk Factors for Carotid Artery Disease
The major risk factors for carotid artery disease, listed below, also are the major risk factors for coronary heart disease (also called coronary artery disease) and peripheral artery disease (P.A.D.).
• Diabetes. With this disease, the body’s blood sugar level is too high because the body doesn’t make enough insulin or doesn’t use its insulin properly. People who have diabetes are four times more likely to have carotid artery disease than are people who don’t have diabetes.
• Family history of atherosclerosis. People who have a family history of atherosclerosis are more likely to develop carotid artery disease.
• High blood pressure (Hypertension). Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)
• Lack of physical activity. Too much sitting (sedentary lifestyle) and a lack of aerobic activity can worsen other risk factors for carotid artery disease, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight or obesity.
• Metabolic syndrome. Metabolic syndrome is the name for a group of risk factors that raise your risk for stroke and other health problems, such as diabetes and heart disease. The five metabolic risk factors are a large waistline (abdominal obesity), a high triglyceride level (a type of fat found in the blood), a low HDL cholesterol level, high blood pressure, and high blood sugar. Metabolic syndrome is diagnosed if you have at least three of these metabolic risk factors.
• Older age. As you age, your risk for atherosclerosis increases. The process of atherosclerosis begins in youth and typically progresses over many decades before diseases develop.
• Overweight or obesity. The terms “overweight” and “obesity” refer to body weight that’s greater than what is considered healthy for a certain height.
• Smoking. Smoking can damage and tighten blood vessels, lead to unhealthy cholesterol levels, and raise blood pressure. Smoking also can limit how much oxygen reaches the body’s tissues.
• Unhealthy blood cholesterol levels. This includes high LDL (“bad”) cholesterol) and low HDL (“good”) cholesterol.
• Unhealthy diet. An unhealthy diet can raise your risk for carotid artery disease. Foods that are high in saturated and trans-fats, cholesterol, sodium, and sugar can worsen other risk factors for carotid artery disease.
Having any of these risk factors does not guarantee that you’ll develop carotid artery disease. However, if you know that you have one or more risk factors, you can take steps to help prevent or delay the disease.
If you have plaque buildup in your carotid arteries, you also may have plaque buildup in other arteries. People who have carotid artery disease also are at increased risk for coronary heart disease.
- Signs and Symptoms of Carotid Artery Disease
Carotid artery disease may not cause signs or symptoms until it severely narrows or blocks a carotid artery. Signs and symptoms may include a bruit, a transient ischemic attack (TIA), or a stroke.
During a physical exam, your doctor may listen to your carotid arteries with a stethoscope. He or she may hear a whooshing sound called a bruit. This sound may suggest changed or reduced blood flow due to plaque buildup. To find out more, your doctor may recommend tests. Not all people who have carotid artery disease have bruits.
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 may have some or all of the symptoms of a stroke. However, the symptoms usually go away on their own within 24 hours.
Stroke and mini-stroke symptoms may 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 just one side of the body
• Trouble speaking or understanding speech
Even if the symptoms stop quickly, call 9–1–1 for emergency help. Do not drive yourself to the hospital. It’s important to get checked and to get treatment started as soon as possible.
A mini-stroke is a warning sign that you’re at high risk of having a stroke. You shouldn’t ignore these symptoms. Getting medical care can help find possible causes of a mini-stroke and help you manage risk factors. These actions might prevent a future stroke.
Although a mini-stroke may warn of a stroke, it doesn’t predict when a stroke will happen. A stroke may occur days, weeks, or even months after a mini-stroke.