• Diagnosing Carotid Artery Disease

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    Physicians have a number of techniques available to them for diagnosing carotid artery disease. Your doctor will first take your medical history, noting risk factors such as high blood pressure, diabetes, or a family history of carotid artery disease. At this time, your physician will also make note of any previous signs of carotid artery disease, such as strokes or transient ischemic attacks (TIAs).

    Your physician will then give you a physical exam. As part of this exam, your doctor may hold a stethoscope over the carotid arteries on each side of your neck and ask you to hold your breath. If your doctor hears a whooshing sound, called a bruit, you may have narrowing of the carotid arteries. This test predicts narrowing of the arteries better than it does impending stroke, and is used as a starting point for diagnosis, rather than confirmation of a diagnosis. Discovery of a bruit may prompt your physician to refer you for diagnostic tests.

    Diagnostic tests

    Carotid ultrasound

    Cartoid Artery Disease UltrasoundA carotid ultrasound uses harmless sound waves to create pictures of the inside of your carotid arteries. A separate test called a Doppler ultrasound can be used to image blood flow through the carotid arteries. Together, these tests can identify narrowing in the carotid arteries. This effective test poses no radiation risks and is painless.

    Computed tomography (CT) angiography

    During a CT scan, the patient lies on a table inside a tube. This tube takes detailed X rays of portions of the human body at different angles to form three-dimensional images. A CT scan can give your physician extensive information about where you may have narrowing in the carotid arteries. For the test, you may also be administered contrast dye, a substance that makes it easier to see the blood vessels. A CT scan uses radiation to form images, so the benefits and risks are weighed before this type of scan is performed.

    Magnetic resonance angiography (MRA)

    You may have heard of magnetic resonance imaging, or MRI. Magnetic resonance angiography (MRA) is an MRI that produces images of blood vessels in the body. MRA, similar to a CT scan, involves having a patient lie on a moveable table that slides into a tube. The machine contains a large magnet that creates a magnetic field. Pulses of radio waves are then sent and received, and a computer interprets these signals and converts them to images. The images show "slices" or sections of the body. This test can sometimes view blood vessels more clearly than an ultrasound or CT scan.

    Cerebral angiography

    For this test, your physician will administer contrast dye, usually through a catheter inserted into a vein in the leg. X rays capture images of the dye traveling through the carotid arteries and indicate places where narrowing may be occurring.

  • More About Carotid Artery Disease

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    Causes of Carotid Artery Disease

    As we age, cholesterol and fatty substances build up in our arteries, causing the arteries to narrow and increasing our risk for cardiovascular disease, including both carotid artery disease and coronary artery (heart) disease.

    Jim Sparacino – Knowing the options for stroke prevention has him singing a new tune.

    While moving band equipment prior to one of his performances, 53-year-old Jim Sparacino began to feel light-headed, a feeling he had become accustomed to over the past few months. A bystander thought Jim was having a heart attack, but his heart was fine. Instead, Jim was suffering from carotid artery disease, which can lead to a stroke. Working with his doctors, Jim explored his treatment options, keeping in mind his need to protect his vocal cords. Read his story and learn which treatment was right for him.

    Lifestyle Changes for People with Carotid Artery Disease

    Once blood flow has been restored, your work-and that of your care team-is not over. Procedures such as carotid angioplasty and stenting or endarterectomy can address serious blockages in the arteries, but they do not control other risk factors or remove plaque build-up throughout all arteries in the body. That's when the focus of treatment turns from procedures to medication and lifestyle changes.

    Symptoms of Carotid Artery Disease

    Carotid artery disease is a gradual process that slowly blocks the artery, and therefore often does not present any warning signs until the artery is almost totally closed. A stroke or a "mini-stroke" (transient ischemic attack) might be your first indicator that your carotid arteries are not healthy.

    Treatment Options for Carotid Artery Disease

    For the last 50 years, a diagnosis of narrowing, or stenosis, in the carotid arteries would most likely result in a recommendation of surgery to prevent stroke. Surgery to remove plaque from the carotid arteries, called a carotid endarterectomy, is still a viable and life-saving procedure that is performed today. However, now more than ever, physicians have latitude to assess the degree of narrowing in the arteries, the age of the patient, and other factors to determine the best course of treatment.

    Your Care Team During Carotid Endarterectomy

    If treating your blockages in the carotid arteries requires that you undergo a surgical procedure, called a carotid endarterectomy, to remove plaque, your cardiologist will refer you to a vascular surgeon. A vascular surgeon has served a five-year residency in general surgery and has had two additional years of training in vascular surgery.