Your carotid arteries are major blood vessels in your neck. If they become blocked, it could cut off the supply of blood to your brain, causing a stroke. Often, blocked carotid arteries have no symptoms, especially if it's just a partial blockage.
Your doctor can evaluate your risks and help you reduce them.
What Causes Blocked Carotid Arteries?
Over time, a waxy substance called plaque builds up in your arteries, narrowing them and making it harder for oxygen-rich blood to travel throughout your body, says the National Heart, Lung, and Blood Institute (NHLBI). When it occurs in the carotid arteries, it's called carotid artery disease.
You're more likely to get carotid artery disease if you have high cholesterol, high blood pressure, diabetes or a history of smoking, says NHLBI. Age is also a factor. According to the Society for Vascular Surgery (SVS), up to 3 percent of people older than 65 may have carotid artery disease.
Signs and Symptoms
"Most people have no symptoms," says Aaron Aday, MD, a cardiovascular expert at Vanderbilt University Medical Center in Nashville. In rare cases, you may have ringing in your ears or fainting. Your doctor may suspect carotid artery disease if:
- A whooshing sound, called a bruit, can be heard through a stethoscope placed on your neck.
- Your eye doctor detects plaque in an artery that brings blood to your eye.
- You have signs or symptoms of a stroke or a transient
ischemic attack (TIA), also called a mini-stroke.
An ultrasound test can help determine if your carotid artery is narrowed and, if so, how severe the problem is, according to SVS.
Dangers of Blocked Carotid Arteries
Particles of plaque can break off and form clots, blocking blood flow to your brain and causing a stroke, says NHLBI. A stroke can lead to permanent disability or death.
One of the easiest ways to remember the signs of stroke is to think "FAST," according to the American Stroke Association.
- F is for face drooping, which often happens on just one side.
- A is for arm weakness — a stroke victim may not be able to hold up both arms.
- S is for speech, which may be slurred and hard to understand.
- T is for time — it's time to
call 911 if you see any of these signs.
Stroke can be treated with a specialized medication to break up the blood clot, but you must be treated within a few hours for it to be effective, says NHLBI. That's why it's critical to call 911 if someone is having stroke symptoms. Don't drive to the hospital.
Carotid artery disease can also cause a TIA, a short-term stroke with symptoms that go away on their own. But Dr. Aday says they're serious medical events that could predict a future stroke. "There's a high risk of stroke or even death in the short term from them," he says. If you think you might have had a TIA in the past, it's important to let your doctor know.
How long can you live with a blocked carotid artery? It varies from person to person, says Dr. Aday. While plaque buildups are common, "not all of them are fragile enough where they'll break off and send particles into the brain and cause symptoms," he says. "Some of them will just be there and be relatively stable over time."
Treatment for Blocked Carotid Arteries
If the artery is less than 60 percent narrowed and isn't causing symptoms, your doctor likely will recommend medical therapy, adds the Society of Vascular Surgeons. This may include cholesterol- and blood pressure-lowering medications and aspirin or another medication to make your blood less sticky.
For a severe blockage, your doctor may recommend carotid endarterectomy — a surgery to remove the blockage — or placement of a stent in the artery to keep it open. Because there are risks with either procedure, including about a 5 percent chance of stroke or death, according to Harvard Health Publishing, it's important to find an experienced heart surgeon.
If your doctor recommends one of these procedures, don't be afraid to ask how many he or she has performed and what percentage of patients have had complications.
Is This an Emergency?
- Society for Vascular Surgery: "Carotid Artery Disease Patient Information Flier"
- Society for Vascular Surgery: "Carotid Artery Disease"
- National Heart, Lung, and Blood Institute: "Carotid Artery Disease"
- Harvard Health Publishing: "Clearing Clogged Arteries in the Neck"
- American Stroke Association: "Stroke Symptoms"
- Aaron Aday, MD, MSc, cardiovascular expert, Vanderbilt University Medical Center, Nashville