Carotid artery disease is a type of cardiovascular disease that affects the carotid arteries, which are the main arteries of the neck that supply blood to the brain. Carotid artery disease is characterized by carotid artery stenosis, or a buildup of plaque in the arteries (atherosclerosis). This causes narrow, stiff veins that cannot efficiently deliver blood to the brain.
Carotid artery disease is a serious condition that can lead to transient ischemic attacks (TIAs or mini strokes), strokes, and in serious cases, death. In the United States, stroke results in approximately 160,000 deaths per year according to the American Heart Association.
Symptoms and Risk Factors of Carotid Artery Disease
Early stages of carotid artery disease do not always present with symptoms. In some cases, the main symptom prior to a stroke is TIA. This ‘mini-stroke’ causes similar symptoms to a stroke yet they are usually temporary. Symptoms of TIA and stroke include:
- Confusion
- Blurred vision
- Memory loss
- Numbness on one side of the body
- Issues with reasoning, memory, or speech
Stroke can lead to permanent disability or death. Early detection of carotid artery disease is essential to prevent stroke and TIA. Many hospitals and clinics offer screening programs for at-risk patients. Risk factors for carotid artery disease can be used to determine who should receive screening. Risk factors include the following:
- Diabetes
- Family history
- High blood pressure and/or cholesterol
- Lack of exercise
- Older age
- Obesity
- Smoking/tobacco use
Understanding risk factors and living a healthy lifestyle are the best ways to prevent carotid artery disease. The American Stroke Association has also created an online calculator to help predict risk of cardiovascular disease, including carotid artery disease.
Treatment for Carotid Artery Disease
Treatment for carotid artery disease varies based on severity. Treatment is targeted to lower risk of stroke and TIA. Lifestyle changes such as quitting smoking and increased exercise can help lower this risk. In addition, medications may be prescribed including:
- Blood thinners such as aspirin
- Antihypertensive medication to reduce blood pressure
- Statin medication to lower cholesterol
A recent addition to medication recommendations by the American Stroke Association includes GLP-1 receptor agonist medications to treat those with diabetes and cardiovascular risk due to obesity. In more severe cases, vascular surgery may be indicated. Procedures may include placing a stent to open a blocked artery or a surgical removal of fatty plaque (carotid endarterectomy).
Why Early Detection with Vascular Ultrasound Matters
Vascular ultrasound exams are a safe, noninvasive, and reliable way to detect carotid artery disease. Vascular ultrasound uses Doppler technology to determine speed and direction of blood flow. A carotid artery duplex ultrasound is a type of specialty Doppler ultrasound used to examine the carotid arteries. This exam can help diagnose carotid artery disease by determining if blood clots are present in the arteries, if the arteries are stiff, and if blood flow is reduced.
Physicians may order a carotid ultrasound if a patient has multiple risk factors for carotid artery disease. Carotid artery ultrasound screening is a risk-free, painless way to determine if a patient has carotid artery disease and is at risk for stroke or TIA. If a patient does have a TIA, a carotid artery exam may be needed afterward to confirm if the cause is carotid artery disease.
During a carotid ultrasound, a technologist will pass the ultrasound transducer (probe/wand) over the neck to image the subclavian, vertebral, internal and external carotid arteries. There are no side effects to vascular ultrasound for carotid artery screening, and it remains the safest and most effective way to detect carotid artery disease.
After the carotid ultrasound, results will be sent to an interpreting physician to review the outcomes. In some cases, this is a credentialed physician such as a Registered Physician in Vascular Interpretation (RVPI) who is qualified to interpret vascular ultrasound results, including those for carotid ultrasound.
Importance of Early Detection with Vascular Ultrasound
Vascular ultrasound for carotid artery screening is an essential tool for early detection of carotid artery disease. Since carotid artery disease is a serious cardiovascular condition that can lead to TIA, stroke or death, early detection is crucial. Lives can be saved when at-risk patients receive quick, efficient screening with vascular ultrasound.
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Frequently Asked Questions (FAQ)
What is a carotid ultrasound?
A carotid ultrasound is a noninvasive imaging test that uses sound waves to examine the carotid arteries in the neck and assess blood flow. It helps detect narrowing, plaque buildup, blood clots, and other signs of carotid artery disease.
What does a carotid ultrasound diagnose?
A carotid ultrasound can help identify carotid artery stenosis, reduced blood flow, arterial stiffness, and the presence of blood clots. It is commonly used to evaluate whether carotid artery disease is present.
Why is carotid artery disease dangerous?
Carotid artery disease can reduce blood flow to the brain and may lead to transient ischemic attacks, stroke, permanent disability, or death. Early detection is important because the condition may not cause symptoms in its early stages.
Who should get a carotid ultrasound screening?
Doctors may order carotid ultrasound screening for patients with multiple risk factors, such as diabetes, high blood pressure, high cholesterol, smoking, obesity, older age, lack of exercise, or a family history of vascular disease.
What are the symptoms of a carotid artery disease or TIA?
Symptoms can include confusion, blurred vision, memory loss, numbness on one side of the body, and problems with reasoning, memory, or speech. In some cases, a TIA is the first warning sign before a stroke.
Is carotid ultrasound painful or risky?
No. Carotid ultrasound is generally painless, safe, and non-invasive, with no side effects described in the article. It is commonly used as a risk-free way to screen for carotid artery disease.
Guest Contributor: Jordan Galerkin
Sources:
- Carotid Artery Disease. Society for Vascular Surgery. https://vascular.org/your-vascular-health/vascular-conditions/common-conditions/carotid-artery-disease
- What is Carotid Artery Disease? Penn Medicine. https://www.pennmedicine.org/conditions/carotid-artery-disease
- Carotid Artery Stenosis. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/16845-carotid-artery-disease-carotid-artery-stenosis
- Carotid Ultrasound. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/carotid-ultrasound/about/pac-20393399
- New Guideline: Preventing a First Stroke May be Possible with Screening, Lifestyle Changes. American Stroke Association. https://newsroom.heart.org/news/new-guideline-preventing-a-first-stroke-may-be-possible-with-screening-lifestyle-changes
- The American Heart Association PREVENT Online Calculator. American Heart Association. https://professional.heart.org/en/guidelines-and-statements/prevent-calculator
- Types of Ultrasound: Doppler vs. Duplex. https://www.ultrasoundquotes.com/blog/doppler-vs-duplex/
