What is Carotid Artery Disease?

Oxygen-rich blood from your heart is carried to other part of your body by your arteries. The arteries that supply blood to your brain are called carotid arteries. They are located on either side of your neck. You can actually feel the pulse of these arteries on your lower neck on each side of your windpipe. If these arteries cannot do their job effectively, it can affect the front part of your brain. This area is responsible for your ability to think, speak, move, and for your personality.

Carotid artery disease occurs when something causes these arteries to be ineffective. If these arteries develop a build up of fat or cholesterol deposits, blood flow is inhibited or stopped, and stroke can occur. The build up of these deposits is known as ‘plaque.’ Your arteries start out as being smooth and unobstructed on the inside. As plaque builds up, the arteries begin to harden. Carotid artery disease takes place when the plaque has increased enough to cause a blockage.

What is a Stroke?

Stroke is the third leading cause of death in the United States, following heart disease and cancer. It is a type of cardiovascular disease.

Your brain needs oxygen and nutrients to survive. These are provided by blood flow. When your brain cells are deprived of these, a stroke occurs. If the blood flow is cut off for more than 3-6 hours, permanent damage can occur.

Are YOU at Risk?

Risk factors for stroke are similar to those of heart disease. They include:

• Smokers
• Diabetics
• People with high cholesterol
• People with high blood pressure
• People with a family history of carotid artery disease
• People with a family history of CAD (coronary artery disease)

Do YOU have symptoms of Carotid Artery Disease?

It is important to note, that you may not have any symptoms. However, there may be warning signs. The following could be signs you’ve suffered a ‘mini-stroke’ or TIA (transient ischemic attack). These should be taken seriously and should be considered an emergency:

• Trouble swallowing
• Difficulty speaking; slurring speech
• Blurred vision or possibly loss of vision- may affect one or both eyes
• Dizziness; clumsiness
• Mental confusion; inability to understand the speech of others
• Numbness on one side of your body in the arm, leg, or face; weakness in these areas

Should YOU change your lifestyle?

Whether you’ve suffered from a stroke, are at risk, or just want to make a few lifestyle adjustments to help ensure a healthier life, you can implement the following changes:

• Begin an exercise program, preferably walking.
• Maintain a healthy diet low in saturated fats and processed foods
• Get regular physical examinations by your health care professional
• Maintain a healthy weight
• Control high blood pressure and high cholesterol
• Limit alcohol consumption
• Quit smoking

Diagnosis of Carotid Artery Disease

As previously stated, this disease may have no symptoms. Your doctor will determine if you are at risk by reviewing your medical and family history. If you are at risk, your doctor will use his stethoscope to listen to the arteries on each side of your neck. He is listening for the sound of your blood rushing through your arteries. If he detects an abnormal sound, it may indicate a blockage. If this is the case, he may order other tests, such as an angiogram, an ultrasound, or a CT scan (commonly called ‘cat’ scan).

An angiogram, also called arteriogram, involves insertion of a catheter into a blood vessel of one of the extremities and guiding it into the carotid artery. Dye is injected to show up on the x-rays and determine if you have a blockage. The x-rays will give a picture of the blood flowing through the vessel. An ultrasound uses sound waves to view the image of your carotid arteries and determine if there is a narrowing in the passages. A probe is placed over the artery to determine the amount of blood flow. A CT scan is generally performed on the brain if a stroke has occurred or is suspected. This test will determine if there are any damaged areas of the brain. It will also show the location and extent of any brain injury.

Treatment of the Disease

If your physician finds you at risk for stroke, he may prescribe medications as treatment. A daily low-dose aspirin is generally prescribed for those at risk, especially if you are an older adult. Also, a blood thinner may be prescribed. Blood thinners, or anticoagulants, help prevent blood clots from forming. They do not dissolve blood clots already present, however. Blood clots not only cause strokes but heart attacks as well.

If a blood thinner is prescribed for you, it is imperative that you have blood tests performed frequently. These can range from weekly to monthly. They determine how quickly your blood clots and the dosage of your medication may be changed to affect the proper clot rate. If you are taking these medications, be sure to keep your doctor aware of any illnesses, diet changes, taking herbal supplements, or medication changes, both prescription and over-the-counter drugs.

Blood thinners come in different brands, but the proper name for a blood thinner is warfarin. A common brand of warfarin is Coumadin. Some foods, especially those high in vitamin K may change the effectiveness of warfarin. Also, alcohol consumption is discouraged while taking this drug. It is imperative you avoid situations or activities where you may be injured as warfarin will keep your blood from clotting quickly due to injuries. Also, you’ll need to consult your doctor before any dental or surgical procedure as he may want you to discontinue use for a few days prior to your procedure.

If taking warfarin, you should call your doctor if you experience:

• Breathing difficulties
• Dizziness, fever, or headache
• Heavy menstrual bleeding, if unusual for you
• Feeling more tired than usual
• Paleness of your skin
• Bruising for unknown reasons
• Changes in appearance/texture of your stools
• Pain or swelling for unknown reasons
• Vomiting
• Hard blow to the head
• Bleeding that has not stopped after ten minutes of pressure.

The Effects and Impact of Stroke

If a stroke occurs, there are several factors that establish its effects on our lives. The amount of time between the stroke and medical treatment is a determining factor on the extent of the damage. Also, the part of the brain that is affected is another issue. With a stroke due to carotid artery disease, the frontal lobe is affected. Behavior may be influenced, as well as memory loss, speech and vision problems, and paralysis.

In America, over 100,000 people die of stroke each year. That’s about one death every three minutes. Ten percent of strokes occur most often in older adults, ages 80-89. Only one percent of adults aged 50-59 have plaque build-up in their carotid arteries. However, it’s never too early to begin a lifestyle of prevention.

External Links:

• American Stroke Association - For More Information about Stroke
• Vascular Web - For More Information about Vascular Health
• Dr. Koop's website - Complete with Arterial Pictures
• South Beach Diet - Healthy diet created by a cardiologist, Dr. Agatston