The carotid arteries are the blood vessels that transfer blood between the heart and the brain. There is one located on each side of the neck. If the plaque builds up enough and breaks off inside the artery, it can cause a blood clot to form. Carotid artery disease occurs when there is a build-up of plaque, a waxy substance made up of cholesterol, calcium, fibrous tissue, and other cellular debris as well as fatty deposits in the carotid arteries. The disease develops slowly over time and can become very serious without showing any previous symptoms. The first sign of the disease may show itself during a stroke or transient ischemic attack (TIA), which is a temporary stoppage in the blood flow to the brain.
Causes, Risk Factors, and Complications of Carotid Artery Disease
Carotid artery disease begins when there is damage to the interior walls of the carotid arteries. The healing process will begin, potentially causing plaque to build up inside the artery. Artery damage can be caused by smoking, high levels of certain fats and cholesterol in the blood, high blood pressure, and high levels of sugar in the blood due to insulin resistance or diabetes. Major complications as a result of carotid artery disease include both stroke and TIA. Stroke can occur when a blood vessel has become so narrowed by plaque that blood can no longer pass through, when a piece of plaque has cracked or ruptured effectively blocking the flow of blood, or when a blood clot forms around a cracked piece of plaque in an attempt to heal the blood vessel.
There are many risk factors for developing carotid artery disease. Some of these include:
- High blood pressure: Excess pressure on the walls of arteries can weaken them and make them susceptible to damage.
- Tobacco use: Nicotine can be irritating to the inner lining of the arteries. Smoking also increases heart rate and blood pressure.
- Diabetes: Diabetes decreases the body’s ability to process fats efficiently, placing you at greater risk of high blood pressure and atherosclerosis (plaque build up inside the arteries).
- High blood-fat levels: High levels of low-density lipoprotein cholesterol and high levels of triglycerides, a blood fat, encourage the accumulation of plaques.
- Family history: The risk of developing carotid artery disease is higher if there is a family history of atherosclerosis or coronary artery disease.
- Age: Arteries lose elasticity and become more prone to injury with age.
- Obesity: Excess weight increases your chances of developing high blood pressure, atherosclerosis, and diabetes.
- Sleep apnea: If you have periods during sleeping where you stop breathing, it could increase your risk of stroke.
- Lack of exercise: It contributes to conditions that damage your arteries, including high blood pressure, diabetes, and obesity.
- Unhealthy diet: Foods that are high in saturated and trans fats, cholesterol, sodium, and sugar can worsen other risk factors for carotid artery disease.
Carotid Artery Disease Symptoms
Carotid artery disease is a medical emergency, as it can result in a stroke if left untreated. Carotid artery disease is the most common cause of stroke in adults in North America. As it is developing, carotid artery disease doesn’t often show any symptoms. The first symptoms may be a stroke or a TIA once the disease has advanced enough to deprive the brain of blood flow. Symptoms of a blockage of blood flow to the brain include numbness or weakness in the face or limbs (sometimes on only one side of the body), trouble speaking and understanding words, trouble seeing, dizziness or loss of balance, and severe headache with no known cause.
How to Diagnose Carotid Artery Disease
Carotid artery disease can be detected prior to stroke, which is why it is important to maintain a regularly scheduled physical exam with your physician. Blocked or clogged arteries make a particular sound when listened to with a stethoscope. This may be detected during a regular exam with your doctor.
Other tests for carotid artery disease include
- Carotid ultrasound: This is a non-invasive, painless screening test using high-frequency sound waves to view the carotid arteries. It looks for plaques and blood clots to determine whether the arteries being blocked. The ultrasound shows the movement of blood through the blood vessels also.
- Magnetic Resonance Angiography (MRA): This imaging technique uses a powerful magnet to gather information about the brain and arteries. A computer can then use this information to generate high-resolution images. An MRA can often detect even small strokes in the brain.
- Computerized Tomography Angiography (CTA): This test is more detailed than an X-ray. A CT uses X-rays and computer technology to produce cross-sectional images of the carotid arteries and images of the brain. This test may reveal areas of damage in the brain.
- Cerebral angiography (carotid angiogram): This procedure is considered the gold standard for imaging the carotid arteries. It is an invasive procedure that lets a doctor see blood flow through the carotid arteries in real time. Cerebral angiography allows the doctor to see narrowing or blockages on a live X-ray screen as contrast dye is injected into the carotid arteries.
Carotid Artery Disease Treatment
If carotid artery disease is discovered before a stroke has occurred, treatment is aimed at preventing stroke. This often includes lifestyle changes and changes to diet. If you are someone who smokes or maintains an unhealthy, sedentary lifestyle, these will need to be changed. If high blood pressure or cholesterol is the cause, medication may be prescribed to help the patient control this.
If the disease is discovered as the causation for a stroke, treatment is aimed at recovering from damage caused by the stroke and preventing further strokes from occurring. This may involve surgery to widen the arteries and remove the blockages already present.
Lifestyle Changes and Prevention of Carotid Artery Disease
Preventing carotid artery disease can be summed up by maintaining a healthy lifestyle. Eat a diet that is low in fat, salt, and sugars to maintain blood pressure and cholesterol. Consume lots of fruits and veggies, as these will fuel your body with natural nutrients it needs to fight off artery-clogging plaque development. Exercise regularly and do your best to keep stressors to a minimum. If you are overweight, losing weight is the best way to prevent the disease developing. If you smoke or drink excessively, stop.
Carotid artery disease is a slow-developing illness that causes severe narrowing or blockages in the carotid arteries on either side of the neck. If left undetected and undiagnosed, carotid artery disease can result in a stroke or TIA. Unfortunately, the disease often shows no signs or symptoms before it becomes serious enough for this to occur.
Causes and risk are often related to medical history or unhealthy lifestyle habits. Other risk factors include underlying medical conditions, such as diabetes. Depending on when the disease is detected, treatment will focus on changing the unhealthy habits of the patient or relieving the underlying cause of the disease, such as high blood pressure or cholesterol. At times, surgery is required.