Carotid artery disease occurs when the major arteries in your neck become narrowed or blocked. These arteries, called the carotid arteries, supply your brain with blood. Your carotid arteries extend from your aorta in your chest to the brain inside your skull.
You are more likely to develop carotid artery disease as you age. Only 1 percent of adults age 50 to 59 have significantly narrowed carotid arteries, but 10 percent of adults age 80 to 89 have this problem.
Carotid artery disease may not cause symptoms in its early stages.
Unfortunately, the first sign of carotid artery disease could be a stroke. However, you may experience warning symptoms of a stroke called transient ischemic attacks, or TIAs.
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Hardening of the arteries (atherosclerosis) causes most cases of carotid artery disease.Experts do not fully understand the cause of hardening of the arteries. Plaque may build up in the arteries because of an injury to the artery’s inner lining. Factors that injure artery walls include smoking, high cholesterol, and high blood pressure.
In rare cases, other conditions known as carotid aneurysm disease and fibromuscular dysplasia can also cause carotid artery disease.
Carotid artery disease causes an estimated 20 to 30 percent of all preventable strokes in adults due to the development of plaque in the main arteries to the brain. In most cases, it is believed to occur when tiny pieces of plaque break free from these arteries in the neck and embolize to small vessels of the brain.
Some patients may experience a brief loss of strength, sensation, vision or speech without lasting damage, referred to as a “mini-stroke” or transient ischemic attack (TIA). These are considered warning signs of an unstable plaque. When an area of brain is irreversibly damaged, some functional deficit remains and a stroke has occurred.
Many patients with a significant condition have no symptoms, but are at risk for a stroke. A simple non-invasive ultrasound test can diagnose carotid artery disease and should be obtained in patients with TIA-like symptoms, those with prior strokes or patients with established risk factors such as age, heart disease, diabetes and hypertension.
To diagnose carotid artery disease, the physician will first obtain a detailed description of the patient’s symptoms. The physician may use a stethoscope to listen to the carotid arteries on both sides of the neck to detect a “bruit” or “whooshing” sound caused by turbulent blood flow in a narrowed carotid artery. Blood pressure measurement in both arms is also an important part of evaluating carotid artery disease to detect possible narrowing in other branches of the blood vessels of the upper body.
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