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The Cleveland Clinic

Heart Disease: Carotid Artery Disease

Your arteries carry oxygen-rich blood away from the heart to the head and body. There are two carotid arteries (one on each side of the neck) that supply blood to the brain. You can feel your carotid arteries by feeling the pulse on your lower neck, on either side of your windpipe.

The carotid arteries supply the large, front part of the brain, which is responsible for our personality and our ability to think, speak and move. There are two smaller arteries, the vertebral arteries, which run through the spine and supply the back part of the brain.

Cartid Artery Disease Illustration

What Is Carotid Artery Disease?

Like the arteries that supply blood to the heart (the coronary arteries), the carotid arteries can also develop atherosclerosis, the build-up of fat and cholesterol deposits, called plaque, on the inside of the vessels. Over time, the plaque narrows the artery, decreases blood flow to the brain and can lead to a stroke. A stroke can occur if:

  • The artery becomes extremely narrowed
  • A piece of plaque breaks off and travels to the smaller arteries of the brain
  • A blood clot forms and blocks a narrowed artery

A stroke is similar to a heart attack. It occurs when brain cells (neurons) are deprived of the oxygen and glucose (a sugar) carried to them by blood. Oxygen and glucose are essential for neurons to function and survive. If the lack of blood flow lasts for more than 3 to 6 hours, the damage is usually permanent.

What Are the Risk Factors For Carotid Artery Disease?

The risk factors for carotid artery disease are similar to those for coronary artery disease:

  • Family history of atherosclerosis (either coronary artery disease or carotid artery disease)
  • Age (greater in men than women less than age 75, but higher in women after age 75)
  • Smoking
  • Hypertension (high blood pressure)
  • Diabetes
  • High levels of low density lipoprotein (LDL, bad cholesterol) - although this link is not as strong as it is for coronary artery disease

If you have coronary artery disease, you are more likely to get carotid artery disease.

What Are the Symptoms of Carotid Artery Disease?

There may not be any symptoms of carotid artery disease. However, there are warning signs of an impending stroke. A transient ischemic attack (also called TIA or "mini-stroke") is one of the most important warning signs of a stroke. A TIA is a temporary episode of:

  • Blurred or loss of vision in one or both eyes
  • Weakness and/or numbness of your arm, leg or face on one side of your body
  • Slurring of speech, difficulty talking or understanding what others are saying
  • Loss of coordination, dizziness or confusion
  • Trouble swallowing

A TIA may last a few minutes or a few hours. A TIA is a medical emergency since it is impossible to predict if it will progress into a major stroke. If you or someone you know experiences these symptoms, get emergency help (Call 9-1-1 in most areas). Immediate treatment can save your life or increase your chance of full recovery.



Next: How is carotid artery disease diagnosed? »

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Carotid Artery Disease

What is a stroke?

A stroke, or cerebrovascular accident (CVA), occurs when blood supply to part of the brain is disrupted, causing brain cells to die. When blood flow to the brain is impaired, oxygen and glucose cannot be delivered to the brain. Blood flow can be compromised by a variety of mechanisms.

Blockage of an artery

  • Narrowing of the small arteries within the brain can cause a so-called lacunar stroke, (lacune=empty space). Blockage of a single arteriole can affect a tiny area of brain causing that tissue to die (infarct).
  • Hardening of the arteries (atherosclerosis) leading to the brain. There are four major blood vessels that supply the brain with blood. The anterior circulation of the brain that controls most motor, activity, sensation, thought, speech, and emotion is supplied by the carotid arteries. The posterior circulation, which supplies the brainstem and the cerebellum, con...

Read the Stroke article »



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