Carotid artery disease occurs when plaque builds up inside the carotid arteries. These arteries supply oxygen-rich blood to the brain.
There are two large common carotid arteries, one on each side of the neck. Each of these arteries separates into an external and internal carotid artery leading up to the brain.
Plaque is a combination of fat, calcium, cholesterol, and other substances. Over time, plaque can build up in these arteries in a process called atherosclerosis.
Plaque buildups narrow the arteries and make it more difficult for blood to get through them.
A narrowed artery poses a serious risk, as it may reduce or block the blood flow to the brain, which could cause a stroke.
In this article, learn more about the symptoms of carotid artery disease, as well as the risk factors and treatment options.
Many people with carotid artery disease do not have any symptoms at first.
Carotid artery disease generally starts causing noticeable symptoms as the condition gets worse.
Severe narrowing of the artery or a blockage in it may cause serious signs and symptoms, including:
A bruit is a sound present in the arteries of some people with carotid artery disease.
During a physical examination, the doctor will place a stethoscope on the neck near the carotid arteries and listen for a slight “whooshing” sound.
Bruit may suggest that the person has reduced blood flow through the artery due to atherosclerosis.
Transient ischemic attack
Some people may not experience symptoms of carotid artery disease until they have a transient ischemic attack (TIA).
A TIA is very similar to a stroke, but it is not as severe. It still requires immediate medical attention, however.
Symptoms of both a TIA and stroke include:
- a sudden, unexplained, severe headache
- loss of balance
- trouble speaking or slurred speech
- vision difficulties, such as trouble seeing out of one or both eyes
- weakness or numbness in the face or limbs, often on one side of the body
- inability to move one or more limbs
Anyone experiencing these symptoms needs urgent medical attention.
If a person experiences a TIA, the symptoms generally go away within the first 24 hours.
A stroke causes the same symptoms as a TIA, but the results may be more severe. A stroke may lead to permanent brain damage due to loss of oxygen.
A stroke may cause permanent vision problems, speech issues, or long-term disability. In some cases, a stroke may lead to paralysis or death.
Anyone who notices signs of a TIA or stroke should seek emergency medical help immediately.
Plaque buildup is the direct cause of carotid artery disease. Although the components of plaque exist in the blood itself, they are more likely to gather in microscopic areas of damage in the arteries.
This damage occurs as a result of genetic factors, as well as the effects of diet and lifestyle choices over time. Major contributing risk factors for damage and plaque buildup in the arteries include:
- unhealthful diet
- high cholesterol
- high blood pressure
- diabetes or insulin resistance
- metabolic syndrome
- lack of physical exercise
- sleep apnea
- older age
People with a family history of any type of atherosclerosis may also have an increased risk of artery disease themselves.
Diagnosing carotid artery disease as early as possible is important to prevent potentially life threatening complications, such as stroke.
A doctor will ask the person about their medical history and lifestyle habits. If the doctor feels that a person may be at risk for carotid artery disease, they may run a physical exam or order other tests to check the person’s blood health.
Listening for a bruit is part of a physical exam. If doctors listen to the arteries and hear a bruit, they will order additional tests.
Doctors generally use one or more imaging tests to see inside the carotid arteries and check for narrowing. Imaging tests include:
A carotid ultrasound uses sound waves to create images of the inside of the arteries.
It is the most common form of imaging test for carotid artery disease, and in most cases, it can help reveal any narrowing of the arteries.
An angiography is an imaging test that uses a special dye to make the arteries show up clearly in the image.
Doctors will inject the dye into the area, then use either X-rays, CT scans, or MRIs to make images of the arteries as the dye passes through them.
This test can help doctors see any narrowing or blockages in the artery.
Treatment for carotid artery disease is vital to reduce the risk of life threatening complications and keep the disease from progressing.
Treatment includes making dietary and lifestyle changes. In some cases, a person may need to take medication or undergo a surgical procedure.
Dietary and lifestyle changes
Dietary and lifestyle changes are an essential part of a treatment plan for carotid artery disease. A doctor may recommend:
- eating a “heart-healthy diet”
- reaching or maintaining a moderate weight
- staying physically active
- quitting smoking, if applicable
- managing other conditions, such as diabetes or heart conditions
General diet tips
The National Heart, Lung, and Blood Institute (NHLBI) note that a general heart-healthy diet includes reducing the intake of:
- saturated fats
- trans fats
- added sugars
Instead, the person should focus on a balanced heart-healthy diet, rich in foods such as:
- whole grains
- low fat dairy products
- lean meats, poultry, and fish
- nuts and seeds
Doctors may also recommend taking medications to help manage carotid artery disease.
Common medications include drugs to keep the blood from clotting, such as aspirin or clopidogrel.
Doctors may recommend additional drugs, such as those that control cholesterol or lower blood pressure, depending on a person’s underlying risk factors.
People who experience symptoms of carotid artery disease or are at risk for major complications may need to have one or more medical procedures to reduce their risk.
Possible procedures include:
Angioplasty and stenting
Angioplasty and stenting can help widen the carotid arteries and increase blood flow to the brain if the person has severe narrowing from plaque.
During an angioplasty procedure, doctors insert a thin tube with a tiny deflated balloon on its end into the narrow artery. With the tube in place, they inflate the balloon, which pushes the plaque out toward the artery wall, helping restore blood flow through the artery.
With the artery expanded, doctors can place a stent — a thin mesh tube — in the area.
The stent will help support and strengthen the artery from the inside, and it will keep the artery from narrowing in that area again.
Endarterectomy is not as common, and may not be right for everyone. Doctors may recommend it for more severe narrowing or blockages.
The NHLBI note that doctors usually only recommend endarterectomy if the person’s arteries are at least 50% blocked.
During this procedure, the surgeon makes a cut into the neck to reach the narrowed artery.
When they find the blockage, they will make a cut in the artery and remove the inner lining in that area. Doing this eliminates the cause of the blockage, which helps restore blood flow.
Carotid artery disease is not the same as coronary artery disease, although they stem from the same issue. Both diseases occur as a result of the buildup of plaque in the arteries. As such, they both have similar risk factors.
However, carotid artery disease is a buildup of plaque in the arteries leading to the brain, whereas coronary artery disease is a buildup of plaque in the arteries leading to the heart.
Getting treatment and making lifestyle changes are vital to give a person the best outlook possible.
People with carotid artery disease who follow their doctor’s treatment plan and make positive lifestyle changes can help prevent the condition from getting worse.
Even with successful treatment, there is no outright cure for carotid artery disease.
However, treatment can reduce the risk of significant events, such as stroke.
Carotid artery disease causes narrowing or blockages in the arteries leading to the brain.
Many health conditions and unhealthful lifestyle choices increase the risk of plaque buildup and carotid artery disease.
Successful treatment includes making dietary and lifestyle changes to reduce the plaque buildup in the arteries and lower the risk of serious complications, such as stroke.
Anyone who notices signs of a stroke, such as slurred speech or weakness, should seek emergency medical attention.