Question: What is (are) Carotid Artery Disease ?
Answer: Carotid artery disease is a disease in which a waxy substance called plaque builds up inside the carotid arteries. You have two common carotid arteries, one on each side of your neck. They each divide into internal and external carotid arteries. The internal carotid arteries supply oxygen-rich blood to your brain. The external carotid arteries supply oxygen-rich blood to your face, scalp, and neck. Carotid Arteries Carotid artery disease is serious because it can cause a stroke, also called a brain attack. A stroke occurs if blood flow to your brain is cut off. If blood flow is cut off for more than a few minutes, the cells in your brain start to die. This impairs the parts of the body that the brain cells control. A stroke can cause lasting brain damage; long-term disability, such as vision or speech problems or paralysis (an inability to move); or death. Overview Carotid artery disease is a major cause of stroke in the United States. Over time, plaque hardens and narrows the arteries. This may limit the flow of oxygen-rich blood to your organs and other parts of your body. Atherosclerosis can affect any artery in the body. For example, if plaque builds up in the coronary (heart) arteries, a heart attack can occur. If plaque builds up in the carotid arteries, a stroke can occur. A stroke also can occur if blood clots form in the carotid arteries. This can happen if the plaque in an artery cracks or ruptures. Blood cell fragments called platelets (PLATE-lets) stick to the site of the injury and may clump together to form blood clots. Blood clots can partly or fully block a carotid artery. A piece of plaque or a blood clot also can break away from the wall of the carotid artery. The plaque or clot can travel through the bloodstream and get stuck in one of the brain's smaller arteries. This can block blood flow in the artery and cause a stroke. Carotid artery disease may not cause signs or symptoms until the carotid arteries are severely narrowed or blocked. For some people, a stroke is the first sign of the disease. Outlook Carotid artery disease is a major cause of stroke in the United States. Other conditions, such as certain heart problems and bleeding in the brain, also can cause strokes.Lifestyle changes, medicines, and medical procedures can help prevent or treat carotid artery disease and may reduce the risk of stroke. If you think you're having a stroke, you need urgent treatment. Call 911 right away if you have symptoms of a stroke. Do not drive yourself to the hospital.You have the best chance for full recovery if treatment to open a blocked artery is given within 4 hours of symptom onset. The sooner treatment occurs, the better your chances of recovery.
Source: NHLBI

Question: What causes Carotid Artery Disease ?
Answer: Carotid artery disease seems to start when damage occurs to the inner layers of the carotid arteries. Major factors that contribute to damage include: Smoking High levels of certain fats and cholesterol in the blood High blood pressure High levels of sugar in the blood due to insulin resistance or diabetes When damage occurs, your body starts a healing process. The healing may cause plaque to build up where the arteries are damaged. The plaque in an artery can crack or rupture. If this happens, blood cell fragments called platelets will stick to the site of the injury and may clump together to form blood clots. The buildup of plaque or blood clots can severely narrow or block the carotid arteries. This limits the flow of oxygen-rich blood to your brain, which can cause a stroke.
Source: NHLBI

Question: How to diagnose Carotid Artery Disease ?
Answer: Your doctor will diagnose carotid artery disease based on your medical history, a physical exam, and test results. Medical History Your doctor will find out whether you have any of the major risk factors for carotid artery disease. He or she also will ask whether you've had any signs or symptoms of a mini-stroke or stroke. Physical Exam To check your carotid arteries, your doctor will listen to them with a stethoscope. He or she will listen for a whooshing sound called a bruit. This sound may indicate changed or reduced blood flow due to plaque buildup. To find out more, your doctor may recommend tests. Diagnostic Tests The following tests are common for diagnosing carotid artery disease. If you have symptoms of a mini-stroke or stroke, your doctor may use other tests as well. Carotid Ultrasound Carotid ultrasound (also called sonography) is the most common test for diagnosing carotid artery disease. It's a painless, harmless test that uses sound waves to create pictures of the insides of your carotid arteries. This test can show whether plaque has narrowed your carotid arteries and how narrow they are. A standard carotid ultrasound shows the structure of your carotid arteries. A Doppler carotid ultrasound shows how blood moves through your carotid arteries. Carotid Angiography Carotid angiography (an-jee-OG-ra-fee) is a special type of x ray. This test may be used if the ultrasound results are unclear or don't give your doctor enough information. For this test, your doctor will inject a substance (called contrast dye) into a vein, most often in your leg. The dye travels to your carotid arteries and highlights them on x-ray pictures. Magnetic Resonance Angiography Magnetic resonance angiography (MRA) uses a large magnet and radio waves to take pictures of your carotid arteries. Your doctor can see these pictures on a computer screen. For this test, your doctor may give you contrast dye to highlight your carotid arteries on the pictures. Computed Tomography Angiography Computed tomography (to-MOG-rah-fee) angiography, or CT angiography, takes x-ray pictures of the body from many angles. A computer combines the pictures into two- and three-dimensional images. For this test, your doctor may give you contrast dye to highlight your carotid arteries on the pictures.
Source: NHLBI

Question: What are the treatments for Carotid Artery Disease ?
Answer: Treatments for carotid artery disease may include healthy lifestyle changes, medicines, and medical procedures. The goals of treatment are to stop the disease from getting worse and to prevent a stroke. Your treatment will depend on your symptoms, how severe the disease is, and your age and overall health. Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have carotid artery disease. Heart-healthy lifestyle changes include: Heart-healthy eating Maintaining a healthy weight Managing stress Physical activity Quitting smoking Heart-Healthy Eating Your doctor may recommend a heart-healthy eating plan, which should include: Fat-free or low-fat dairy products, such as skim milk Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week Fruits, such as apples, bananas, oranges, pears, and prunes Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Vegetables, such as broccoli, cabbage, and carrots Whole grains, such as oatmeal, brown rice, and corn tortillas When following a heart-healthy diet, you should avoid eating: A lot of red meat Palm and coconut oils Sugary foods and beverages Two nutrients in your diet make blood cholesterol levels rise: Saturated fatfound mostly in foods that come from animals Trans fat (trans fatty acids)found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats andmeats. Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples: If you eat: Try to eat no more than: 1,200 calories a day 8 grams of saturated fat a day 1,500 calories a day 10 grams of saturated fat a day 1,800 calories a day 12 grams of saturated fat a day 2,000 calories a day 13 grams of saturated fat a day 2,500 calories a day 17 grams of saturated fat a day Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are: Avocados Corn, sunflower, and soybean oils Nuts and seeds, such as walnuts Olive, canola, peanut, safflower, and sesame oils Peanut butter Salmon and trout Tofu Sodium You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and no added salt foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more. Dietary Approaches to Stop Hypertension Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt. The DASH eating plan is a good heart-healthy eating plan, even for those who dont have high blood pressure. Read more about DASH. Alcohol Try to limit alcohol intake. Too much alcohol can raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is: 12 ounces of beer 5 ounces of wine 1 ounces of liquor Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and can lower your risk for carotid artery disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active. Knowing your body mass index (BMI) helps you find out if youre a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institutes (NHLBI) online BMI calculator or talk to your doctor. A BMI: Below 18.5 is a sign that you are underweight. Between 18.5 and 24.9 is in the normal range. Between 25 and 29.9 is considered overweight. Of 30 or more is considered obese. A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal. Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, youre at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk. If youre overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol. Managing Stress Managing and coping with stress. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as: A stress management program Meditation Physical activity Relaxation therapy Talking things out with friends or family Physical Activity Routine physical activity can lower many risk factors for coronary heart disease, including LDL (bad) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the good cholesterol that helps prevent coronary heart disease. Everyone should try to participate in moderate-intensity aerobic exercise at least 2hours and 30minutes per week, or vigorous aerobic exercise for 1hour and 15minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10minutes at a time spread throughout the week. Read more about physical activity at: Physical Activity and Your Heart U.S. Department of Health and Human Services 2008 Physical Activity Guidelines forAmericans Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you. Quitting Smoking If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Read more about quitting smoking at Smoking and Your Heart. Medicines If you have a stroke caused by a blood clot, you may be given a clot-dissolving, or clot-busting, medication. This type of medication must be given within 4 hours of symptom onset. The sooner treatment occurs, the better your chances of recovery. If you think youre having a stroke, call 911 right away for emergency care. Medicines to prevent blood clots are the mainstay treatment for people who have carotid artery disease. They prevent platelets from clumping together and forming blood clots in your carotid arteries, which can lead to a stroke. Two common medications are: Aspirin Clopidogrel Sometimes lifestyle changes alone arent enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Diabetes Heart disease or have had a stroke High LDL cholesterol levels Doctors may discuss beginning statin treatment with those who have an elevated risk for developing heart disease or having a stroke. You may need other medications to treat diseases and conditions that damage the carotid arteries. Your doctor also may prescribe medications to: Lower your blood pressure. Lower your blood sugar level. Prevent blood clots from forming, which can lead to stroke. Prevent or reduce inflammation. Take all medicines regularly, as your doctor prescribes. Dont change the amount of your medicine or skip a dose unless your doctor tells you to. Your health care team will help find a treatment plan thats right for you. Medical Procedures You may need a medical procedure if you have symptoms caused by the narrowing of the carotid artery. Doctors use one of two methods to open narrowed or blocked carotid arteries: carotid endarterectomy and carotid artery angioplasty and stenting. Carotid Endarterectomy Carotid endarterectomy is mainly for people whose carotid arteries are blocked 50percent ormore. For the procedure, a surgeon will make a cut in your neck to reach the narrowed or blocked carotid artery. Next, he or she will make a cut in the blocked part of the artery and remove the arterys inner lining that is blocking the blood flow. Finally, your surgeon will close the artery with stitches and stop any bleeding. He or she will then close the cut in your neck. Carotid Endarterectomy Carotid Artery Angioplasty and Stenting Doctors use a procedure called angioplasty to widen the carotid arteries and restore blood flow to the brain. A thin tube with a deflated balloon on the end is threaded through a blood vessel in your neck to the narrowed or blocked carotid artery. Once in place, the balloon is inflated to push the plaque outward against the wall of the artery. A stent (a small mesh tube) is then put in the artery to support the inner artery wall. The stent also helps prevent the artery from becoming narrowed or blocked again. Carotid Artery Stenting
Source: NHLBI

Question: How to prevent Carotid Artery Disease ?
Answer: Taking action to control your risk factors can help prevent or delay carotid artery disease and stroke. Your risk for carotid artery disease increases with the number of risk factors you have. One step you can take is to adopt a heart-healthy lifestyle, which can include: Heart-Healthy Eating. Following heart-healthy eating is an important part of a healthy lifestyle. Dietary Approaches to Stop Hypertension (DASH)is a program that promotes heart-healthy eating. Maintaining a Healthy Weight. If youre overweight or obese, work with your doctor to create a reasonable plan for weight loss. Controlling your weight helps you control risk factors for carotid arterydisease. Physical Activity. Be as physically active as you can. Physical activity can improve your fitness level and your health. Ask your doctor what types and amounts of activity are safe for you. Read more about Physical Activity and Your Heart. Quit Smoking. If you smoke, quit. Talk with your doctor about programs and products that can help you quit. Other steps that can prevent or delay carotid artery disease include knowing your family history of carotid artery disease. If you or someone in your family has carotid artery disease, be sure to tell your doctor. If lifestyle changes arent enough, your doctor may prescribe medicines to control your carotid artery disease risk factors. Take all of your medicines as your doctor advises.
Source: NHLBI