Carotid Artery Disease (Part 2 of 3)
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Factors that stress your arteries and increase the risk of injury, buildup of plaques and disease include the following:
High blood pressure. High blood pressure is an important risk factor for carotid artery disease. Excess pressure on the walls of your arteries can weaken them and leave them more vulnerable to damage.
Smoking. Nicotine can irritate the inner lining of your arteries. It also increases your heart rate and blood pressure.
Age. As you age, your arteries become less elastic and more prone to injury.
Abnormal blood-fat levels. High levels of low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol, and high levels of triglycerides, a blood fat, encourage the accumulation of plaques.
Diabetes. Diabetes affects not only your ability to handle glucose appropriately but also your ability to process fats efficiently, placing you at greater risk of high blood pressure and atherosclerosis.
Obesity. Carrying excess pounds increases your chances of high blood pressure, atherosclerosis and diabetes.
Heredity. Having a family history of atherosclerosis or coronary artery disease increases your risk of developing these conditions, as well.
Physical inactivity. Lack of exercise contributes to a number of conditions, including high blood pressure, diabetes and obesity.
Often, these risk factors occur together, creating even greater risk than if they occur alone.
The most serious complication of carotid artery disease is stroke. There are different ways carotid artery disease can increase your risk of stroke:
Reduced blood flow. A carotid artery may become so narrowed by atherosclerosis that not enough blood is able to reach portions of your brain.
Ruptured plaques. A piece of a plaque may break off and flow to smaller arteries in your brain (cerebral arteries). The fragment may get stuck in one of these smaller arteries, creating a blockage that cuts off blood supply to the area of the brain that the cerebral artery serves.
Blood clot blockage. Some plaques are prone to cracking and forming irregular surfaces on the artery wall. When this happens, your body reacts as if to an injury and sends platelets — blood cells that help the clotting process — to the area. A large blood clot may develop in this manner and block or slow the flow of blood through a carotid or cerebral artery, causing a stroke.
A stroke can leave you with permanent brain damage and muscle weakness. In severe cases, it can be fatal.
TEST AND DIAGNOSIS
In addition to taking a thorough medical history and recording risk factors and any signs or symptoms, your doctor may conduct or request several tests to evaluate the health of your carotid arteries:
Physical examination. Your doctor may hear a “swooshing” sound (bruit) over the carotid artery in your neck, a sound that’s characteristic of a narrowed artery. Your doctor may perform a neurological evaluation to test your physical and mental status such as strength, memory and speech capabilities.
Ultrasound. A common, noninvasive test used to check for carotid artery disease is a Doppler ultrasound. This variation of the conventional ultrasound assesses blood flow and pressure — and possible narrowing of the blood vessel — by bouncing high-frequency sound waves (ultrasound) off red blood cells.
Computerized tomography angiography (CTA). This imaging test uses a contrast dye to highlight your carotid arteries in the pictures taken. The dye is injected into a blood vessel. When it travels to your carotid arteries, a computerized tomography (CT) scan gathers X-ray images of your neck and brain from many angles.
Head computerized tomography (CT). This imaging looks at the brain tissue, without giving dye, to rule out bleeding or other abnormalities.
Magnetic resonance angiography (MRA). Like CTA, this imaging test uses a contrast (noniodine) dye to highlight the arteries in your neck and brain. A magnetic field and radio waves are used to create cross-sectional, 3-D images.
Magnetic resonance imaging (MRI). Like CT, this imaging test looks at the brain tissue for evidence of early stroke or other abnormalities.
Cerebral angiogram. A more traditional, and more invasive, imaging procedure called a cerebral angiogram may sometimes be done, but its use is less common as it carries a slight risk of stroke. In this procedure, contrast dye is injected with a catheter that’s been threaded directly into your carotid arteries. Detailed X-ray images are then taken.