What is Carotid Disease?

The carotid arteries, located on each side of your neck, deliver oxygen-rich blood to your brain and head. Carotid disease usually occurs due to atherosclerosis – a build-up of fatty deposits (plaque) inside the artery walls. This plaque hardens and narrows the arteries, restricting blood flow. A piece of plaque can also break off and travel to the brain, or a blood clot can form on the plaque, both leading to a stroke.

Symptoms of Carotid Disease

Often, carotid disease develops slowly and may show no symptoms until it’s quite advanced. The first sign for many can be a Stroke or a Transient Ischemic Attack (TIA), sometimes called a “mini-stroke.”

Symptoms of a TIA or Stroke are sudden and can include:

• Sudden numbness or weakness in the face, arm, or leg, usually on one side of the body.

• Sudden trouble speaking or understanding speech.

• Sudden trouble seeing in one or both eyes.

• Sudden dizziness, loss of balance, or coordination.

• Sudden, severe headache with no known cause.

If you experience any of these symptoms, seek immediate emergency medical attention.

Causes and Risk Factors

The primary cause is atherosclerosis. Risk factors for developing carotid disease are similar to those for other heart and vascular conditions:

• Smoking cigarettes or Vaping nicotine: A major risk factor that damages arteries.

• High Blood Pressure (Hypertension): Puts strain on and eventual damage to artery walls.

• High Cholesterol: Contributes to plaque build-up and can make existing plaques unstable.

• Diabetes: Long term elevated blood sugar levels damages blood vessels.

• Obesity.

• Age: Risk increases with age.

• Family History: A genetic predisposition to heart disease or stroke.

• Physical Inactivity.

Diagnosis and Treatment

Early diagnosis is crucial to prevent stroke. Your doctor may:

• Perform a physical exam, listening for a “bruit” (a whooshing sound) in your neck.

• Order a Duplex Ultrasound of your carotid arteries to see blood flow and blockages.

• In some cases, CT Angiography (CTA) or MR Angiography (MRA) may be used for more detailed images.

Treatment aims to prevent stroke and manage symptoms:

Lifestyle Changes & Medications

• Quitting smoking or vaping is essential.

• Regular exercise and a healthy diet.

• Weight management.

• Strict control of blood pressure, cholesterol, and diabetes.

• Medications such as antiplatelet drugs (e.g., aspirin) to prevent clots, and statins to lower cholesterol and stabilise arterial plaque.

Procedures & Surgery

For significant blockages, or if you’ve had a recent TIA or stroke, your doctor might recommend:

• Carotid Endarterectomy: A surgical procedure to open the artery and remove the plaque.

• Carotid Angioplasty and Stenting: A minimally invasive procedure where a balloon widens the artery, and a stent (small mesh tube) is placed to keep it open.

Preventing Carotid Disease

You can significantly reduce your risk of carotid disease and stroke by adopting a heart-healthy lifestyle:

• Don’t smoke or Vape.

• Eat a balanced, healthy diet.

• Exercise regularly.

• Maintain a healthy weight.

• Manage existing conditions like diabetes, high blood pressure, and high cholesterol with your doctor.

If you have risk factors or concerns about carotid disease, talk to your GP. Early detection and management can be life-saving.