Get to the heart of a life-threatening health condition that puts your neck on the line.

When you think about keeping your brain healthy, you may not picture your neck — but you should. Inside your neck are your carotid arteries. These two large arteries are responsible for transporting blood to your head and brain. When the carotid arteries get narrow or become blocked, the diagnosis is carotid artery disease.

One of the most common causes of carotid artery disease is plaque. Consisting of cholesterol, calcium, fat and other substances, plaque builds up inside artery walls. When this happens to coronary arteries — the ones feeding your heart — the heart doesn’t get enough blood flow. This results in coronary artery disease (CAD). If not kept in check, it can cause a heart attack. Unchecked carotid artery disease, on the other hand, can cause stroke.

Recognize carotid artery disease symptoms.

Your risk for carotid artery disease increases with high blood pressure, high cholesterol, diabetes and smoking. However, carotid artery disease, like other vascular diseases, doesn’t always give warning signs. As a result, many people don’t catch the disease until it has progressed. When symptoms do arise, they typically include one or more of the following:

• Bruit — An abnormal whooshing sound made by the carotid arteries. Researchers suspect this sound likely occurs when plaque buildup causes a reduction or other change in blood flow. You likely won’t feel or hear this symptom on your own.
• Stroke — In America, stroke is a leading cause of disability and the number five cause of death. Stroke is characterized by sudden weakness or numbness in the face or limbs (often only experienced on one side), loss of balance or dizziness, difficulty speaking or understanding speech, vision problems or onset of severe headache for no known reason.
• Transient ischemic attack (TIA) — Also known as a mini-stroke, TIAs cause all the symptoms of a regular stroke. The only difference? Symptoms typically go away within 24 hours. However, you still need follow-up medical care.

How is carotid artery disease diagnosed?

Once carotid artery disease is suspected, getting to the bottom of the issue can help prevent future problems. The first step to diagnosis is going over your medical history and performing a physical exam. During the exam, a member of the Tanner Health System vascular care team will use a stethoscope to listen to your carotid arteries. This allows your provider to determine if a bruit is present.

Regardless of the presence of a bruit, other tests are needed for definitive diagnosis. The most common test is carotid ultrasound. Using harmless sound waves, ultrasound visualizes the insides of your blood vessels and carotid arteries. This is essentially the same technology used to visualize babies in utero.

Other common tests include MRI and CT. When necessary, a special dye is injected into your arteries to make them show up more clearly on the exams.

In some cases, non-invasive imaging is complemented with carotid angiography. For this procedure, a catheter (a thin, flexible tube) is inserted into your groin. A provider carefully guides the catheter to the carotid artery. Once in place, a special dye is injected into the artery and special X-ray technology pictures your arteries. This is normally used when carotid ultrasound doesn’t provide a sufficiently clear image.

How do doctors treat carotid artery disease?

Because carotid artery disease increases your risk for stroke, having the condition diagnosed and treated is vital. Depending on your specific case, your treatment may range from lifestyle changes to surgery.

Lifestyle modification — The first step to treating carotid artery disease is lifestyle changes. For healthy carotid arteries, you shouldn’t smoke. If you do, quit. You should also eat a healthy, low-fat diet full of fruits and vegetables. Get regular exercise, and keep an eye on your blood pressure and cholesterol levels.

Medication — When lifestyle changes aren’t enough, medication can help. High blood pressure and cholesterol increase your risk for and complications from carotid artery disease. Medication to manage these conditions can help manage carotid artery disease. As an added perk, medication and lifestyle changes provide increased protection for your heart.

Surgery — In the event your carotid artery is blocked more than 60%, your provider may recommend surgery. In an angioplasty and stenting procedure, a doctor guides a catheter to the blocked area. A tiny balloon is passed through the catheter and inflated inside the clogged artery, opening the artery wide. A wire mesh tube (stent) is then inserted in the artery to keep the artery open. A second surgical option is carotid endarterectomy. This involves cleaning the plaque out of your carotid artery through an incision in front of the neck.

No matter which treatment you need, regular follow-up care ensures it is effective. If you suspect you’re having a stroke, call 911 immediately.

Learn more about vascular care at Tanner Health System.