Carotid Artery Disease Screening
The carotid arteries are the two large blood vessels on each side of the neck that supply blood to the brain. When a carotid artery become clogged with plaque, they become narrower, affecting blood flow. Complications can be serious. If any of the plaque breaks off, it can block the blood flow to the brain completely, causing a stroke. The carotid artery screening uses ultrasound to identify the presence of plaque in the carotid arteries, which can develop over time without causing any symptoms.
What is carotid artery disease?
Carotid artery disease, sometimes referred to as carotid stenosis, occurs when plaque starts to collect and build up in the carotid arteries. You have two carotid arteries, one on each side of the neck, which carry blood to the brain. Plaque is made up of cholesterol, calcium, and other cellular substances and it can collect in the arteries, making the arteries stiffer and narrower. This is defined as carotid artery disease, which is a form of atherosclerosis. Clogged arteries do not deliver blood and oxygen as well as they should to the brain. Carotid artery disease develops slowly over time as people age, and most people have no symptoms. In fact, for 4 out of 5 people who have a stroke, the first symptom they experience is the stroke.
People who have carotid artery disease, which is a form of atherosclerosis, can often have plaque buildup in arteries in other parts of the body as well. Carotid artery disease is a major risk factor for stroke, because plaque can either break off and travel to the brain, or it can block blood flow to the brain. A stroke is a medical emergency, because the loss of blood supply causes the brain cells to begin to die within minutes.
The best way to check for carotid artery disease is to undergo a screening. The non-invasive ultrasound screening for carotid artery plaque is painless and does not require the removal of any clothing. While the participant reclines on their back, the technician will use color flow ultrasound technology to create images of the carotid arteries while also measuring blood flow through them. After a board-certified physician reviews your results from the screening, the results letter will indicate the degree of plaque buildup for each of your two arteries on a scale of normal (no plaque identified and blood flow is normal) to significant (large amount of plaque identified, and blood flow is significantly reduced).
This allows people with normal, mild, or moderate carotid artery blockage to compare the results of each screening to previous screening results, determining if the plaque buildup has gotten worse. Plaque buildup can be progressive without treatment, getting worse over time. Early identification of risk, before symptoms are present, allow you and your doctor to take action if necessary. Plaque buildup (atherosclerosis) can occur in any of the arteries in the body. This is one reason the simple ultrasound of the carotid arteries is so valuable: it helps people understand their risk of developing atherosclerosis in other areas of the body as well.
Physicians who are on the front lines of vascular disease believe in these tests—9 out of 10 cardiovascular doctors support preventive health screenings for cardiovascular disease among people with key risk factors.
If plaque buildup in your carotid arteries is identified, you should discuss these results with your personal physician. If you are diagnosed with carotid artery disease, he or she will most likely recommend lifestyle changes, including changing your diet to be low in saturated fat and sodium, ensuring you exercise regularly, and monitoring and managing your blood pressure and cholesterol levels. Treatment may include medications to thin the blood or to prevent the blood from clotting. If a lifestyle change or treatment plan is ineffective, carotid artery disease could require surgery. A carotid endarterectomy is the surgery that removes plaque buildup from your arteries. The procedure restores normal blood flow to the brain, which prevents the likelihood of a stroke. However, only in the most serious cases of carotid artery disease is a carotid endarterectomy recommended—that’s the value of being screened before you have symptoms and while you and your doctor can still act.
What are the warning signs of carotid artery disease?
In its early stages, carotid artery disease develops silently, without causing any pain, discomfort, or any other symptoms. That is the primary reason that getting a screening for carotid artery disease is so important—especially for those people who have risk factors for developing cardiovascular disease. Plaque buildup can go unnoticed until it is serious enough to affect the flow of blood to the brain, and potentially lead to a stroke.
The warning signs of a stroke are:
- Sudden numbness or weakness in arms or legs, which may only be present on one side of the body
- Facial drooping, which can affect only one side of the face
- Sudden difficulty talking
- Severe headache
- Sudden trouble seeing
What causes carotid artery disease?
There are several contributing factors to carotid artery disease, many of which also contribute to other kinds of heart disease, so it’s important schedule a screening in order to determine exactly what’s happening. The contributing factors are:
- Age 55+
- Family history of cardiovascular disease, heart disease, or stroke
- Smoking (past or present)
- High Blood Pressure
- High Cholesterol
Who should get a carotid artery screening?
A carotid artery ultrasound is appropriate for all adults age 55+, and adults age 40+ with two or more risk factors for cardiovascular disease (see list at right). Many people age 40+ who want to be proactive about their health also feel this screening is right for them, regardless of risk factors. Discussing the screening with your doctor is always recommended.
Carotid artery disease screening is appropriate for all adults age 55+. It is also appropriate for adults age 40+ who have risk factors for cardiovascular disease, and who want to be proactive about their health.
People at risk for developing cardiovascular disease can benefit from having an ultrasound for carotid artery disease every year, especially if previous screenings have indicated the presence of plaque in the arteries.
1Seshadri S, Beiser A, Kelly-Hayes M, et al., The Lifetime Risk of Stroke: Estimates from the Framingham Study. Stroke, 2006; 37:345-350.
2Key risk factors include diabetes, obesity, age 55+, smoking (past or present), high blood pressure, high cholesterol, and a family history of stroke or heart disease.