What is carotid artery disease?

A carotid artery on each side of the neck supplies blood to the brain. Carotid artery disease occurs when a substance called plaque builds up in either or both arteries. The buildup may narrow the artery and limit blood flow to the brain. If this plaque breaks open, it may form a blood clot. Or pieces of the plaque may break off. A piece of plaque or a blood clot could move to the brain and cause a stroke or transient ischemic attack (TIA).

The narrowing in an artery is called stenosis. The more narrow an artery becomes, the greater the risk of stroke or TIA.

Many people have no symptoms. In some people, a doctor can hear a sound in their neck called a bruit (pronounced "broo-EE"). This is a whooshing sound that happens when a carotid artery is narrowed.

For some people, a transient ischemic attack (TIA) or stroke is the first sign of the disease.

If you have any of these symptoms of a TIA or stroke, call 911 or other emergency services right away.

• Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
• Sudden vision changes.
• Sudden trouble speaking.
• Sudden confusion or trouble understanding simple statements.
• Sudden problems with walking or balance.
• A sudden, severe headache that is different from past headaches.

An ultrasound test is used to diagnose carotid artery disease. This test uses sound waves to show how blood flows through your carotid arteries. You may have other tests such as a CT angiogram or a magnetic resonance angiogram (MRA) to check your carotid arteries.

Screening tests for carotid artery disease are not recommended for people who do not have signs or symptoms of carotid artery disease. If you have risk factors, signs, or symptoms of carotid artery disease, your doctor may recommend an ultrasound test to check for it.

Some companies sell ultrasound screening. But insurance doesn't pay for these tests because experts don't recommend them. And since your doctor didn't prescribe the tests, they aren't there to explain the results to you. It's a good idea to talk to your doctor before having one of these tests.

The goal of treatment is to lower your risk of having a stroke. This can be done in several ways.

• Medicine. This includes medicines to prevent blood clots, manage high blood pressure, and lower cholesterol.
• A heart-healthy lifestyle. This includes healthy eating, being active, staying at a weight that's healthy for you, managing other health problems, and not smoking or vaping.
• Regular ultrasounds. These may be done to see if your arteries are getting narrower.
• Surgery or a procedure. A surgery called an endarterectomy may be done to remove plaque from the artery. Some people have a procedure that places a stent inside a carotid artery.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You may take medicine to lower your blood pressure, to lower your cholesterol, or to prevent blood clots.
• If you take a blood thinner, such as aspirin, be sure to get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.
• Try to quit smoking. If you can't quit, cut back as much as you can. People who smoke have a higher chance of stroke than those who quit. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Eat heart-healthy foods. These foods include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. You limit things that are not so good for your heart, like sodium, alcohol, and sugar.
• Stay at a weight that's healthy for you. Talk to your doctor if you need help with this.
• Be active. Ask your doctor what type and level of exercise is safe for you.
• Limit alcohol to 2 drinks a day for men and 1 drink a day for women. Too much alcohol can cause health problems.
• Manage other health problems such as diabetes, high blood pressure, and high cholesterol. If you think you may have a problem with alcohol or drug use, talk to your doctor.
• Avoid infections such as COVID-19, colds, and the flu. Get the flu vaccine every year. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Stay up to date on your COVID-19 vaccines.