Heart Disease: Carotid Artery Disease

Your arteries carry oxygen-rich blood away from the heart to the head and body. There are two carotid arteries (one on each side of the neck) that supply blood to the brain. The carotid arteries can be felt on each side of the neck, immediately below the angle of the jaw.

There are two smaller arteries called the vertebral arteries that supply blood to the back part of the brain (the brainstem and cerebellum).

The carotid arteries supply blood to the large, front part of the brain, where thinking, speech, personality and sensory and motor functions reside.

What Is Carotid Artery Disease?

Carotid artery disease, also called carotid artery stenosis, is the narrowing of the carotid arteries, usually caused by the buildup of fat and cholesterol deposits, called plaque. Like the arteries that supply blood to the heart (the coronary arteries), the carotid arteries can also develop atherosclerosis on the inside of the vessels.

Over time, the buildup of fat and cholesterol narrows the carotid arteries, decreasing blood flow to the brain and increasing the risk of a stroke. A stroke is similar to a heart attack. It occurs when brain cells (neurons) are deprived of the oxygen and glucose (a sugar) carried to them by blood. Oxygen and glucose are essential for neurons to function and survive. If the lack of blood flow lasts for more than 3 to 6 hours, the damage is usually permanent. A stroke can occur if:

• The artery becomes extremely narrowed.
• A piece of plaque breaks off and travels to the smaller arteries of the brain.
• A blood clot forms and blocks a narrowed artery.

A stroke can occur as a result of other conditions, such as sudden bleeding in the brain (intracerebral hemorrhage), sudden bleeding in the spinal fluid space (subarachnoid hemorrhage), atrial fibrillation, cardiomyopathy or blockage of tiny arteries inside the brain.

What Are the Risk Factors For Carotid Artery Disease?

The risk factors for carotid artery disease are similar to those for coronary artery disease:

• Family history of atherosclerosis (either coronary artery disease or carotid artery disease)
• Age (men under age 75 have a greater risk of developing the disease than women, but the risk is higher in women after age 75)
• Smoking
• Hypertension (high blood pressure)
• Diabetes
• Obesity
• Lack of exercise

Typically, the carotid arteries become diseased a few years later than the coronary arteries. People who have coronary artery disease have an increased risk of developing carotid artery disease.

What Are the Symptoms of Carotid Artery Disease?

There may not be any symptoms of carotid artery disease. However, there are warning signs of an impending stroke. A transient ischemic attack (TIA) is one of the most important warning signs of a stroke. A TIA occurs when a blood clot briefly blocks an artery that supplies blood to the brain. The symptoms of a TIA, which are temporary and may last a few minutes or a few hours, can occur alone or in combination: