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Are You Risking Your Neck?

Carotid Artery Disease - A "Silent" Trigger for Stroke

A pain in the neck may be the least of your worries if you have carotid artery disease (CAD).

"The problem is that patients may have no symptoms or warning signs when there's a blockage in the carotid arteries," said Dr. Frank Pomposelli, Chief of Vascular and Endovascular Surgery at Beth Israel Deaconess Medical Center and the CardioVascular Institute. "Unfortunately for some patients, their first symptom may be a stroke."

Carotid Artery Disease (CAD)

The carotid arteries are the large blood vessels on either side of your neck that run from the aorta in your chest to your brain. They are the primary sources for blood and oxygen to the head and front part of the brain - the part that encompasses thought, speech, personality and other functions that make you "you." If you have ever noticed a pulse thrumming just below your jaw, this was blood flowing through your carotid arteries.

Result of Atherosclerosis

The carotid arteries can become restricted or blocked - just like the arteries that supply blood to the heart - due to atherosclerosis. Atherosclerosis occurs when cholesterol and fat begin to build up on the inside of arteries, eventually forming a plaque that narrows and "hardens" the arteries.

"Carotid artery disease is a disease that primarily affects people who are aged 60 or older, and the risk increases with age," said Pomposelli. "But other risk factors are also associated with the occurrence of carotid disease, and it can occur earlier in life in people with one or more risk factors."

Risk Factors for CAD

Risk factors linked to carotid artery disease include:

See Your Doctor Regularly

"For patients with risk factors for atherosclerosis and carotid artery disease, it's important to see your doctor regularly to be sure high blood pressure, high cholesterol and diabetes are well controlled," explained Pomposelli. "Your doctor can also help you with stopping smoking and losing weight. Sometimes your doctor will detect the sound of turbulent blood flow in the neck (called a bruit) with a stethoscope, which will alert them to need to test for carotid artery disease."

Transient Ischemic Attack (TIA)

In other cases, patients may experience the symptoms of a transient ischemic attack or TIA, often referred to as a 'mini stroke.' TIA symptoms are similar to stroke symptoms, but they only last for a few minutes to a few hours. Typical symptoms include clumsiness, weakness, paralysis or numbness of an extremity or the face, partial or complete loss of vision in one eye and loss of the ability to speak. The occurrence of TIA in the presence of significant carotid artery blockage greatly increases the risk of stroke, and patients having symptoms of TIA should seek medical treatment immediately.

Treatment for CAD

Treatments for mild or moderate carotid artery disease include the use of medications to lower cholesterol such as statins and aspirin and other medications to reduce the formation of blood clots.

For severe narrowing of the carotid artery, especially in patients with symptoms of TIA or those who have already suffered a stroke, a surgical procedure known as a carotid endarterectomy may be necessary. This procedure involves opening the artery to remove plaque. A newer procedure, carotid stenting, may be used as an alternative to surgery. Carotid stenting places a small wire mesh tube within the plaque inside the artery to keep it open.

Preventive Measures for CAD

But, if you really want to "save your neck," the best methods to slow or stop carotid artery disease are preventive.

"A healthy lifestyle provides the best long-term risk reduction for carotid artery disease and stroke," said Pomposelli. "That includes preventive measures such as avoiding smoking, eating a healthy diet, keeping your weight down and exercising regularly. It's also important to aggressively treat high blood pressure, diabetes and high serum cholesterol levels."

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted October 2010

Contact Information

CardioVascular Institute at
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215