Doctor insights on:
Carotid Artery Disease Chest Pain
I am having carotid artery sharp pain on right side and shoulder neck arm pain along with chest pain in center. Is this serious?
Could be: That could be serious. The most troublesome thing you said is that you have chest pain in the center. Undiagnosed chest pain in a 47 year old who reports, as you do, a history of angina, should be further evaluated, especially if it's new, occurring more often, with less effort, lasting longer, or getting worse. ...Read more
Arteries are defined as blood vessels which carry blood away from the heart (to either the body or lungs). Arteries: higher pressure, thicker walls, stretch (pulse) with each heart contraction & deliver blood to the arterioles which control the flow to individual capillaries. Veins are blood vessels which carry blood from capillaries back to the heart (body to right heart; ...Read more
Carotid Artery: Disease= a number pathologic processes that affect the carotid arteries. In common usage it generally implies atherosclerotic disease. ...Read more
Very rarely, if ever.: Usual is amaurosis fugax, like a shade coming down over the vision of one eye only, but not both. An unusual variation is bright light amaurosis, brought on in one eye when in bright light, because the extra light puts more demand on the retina.The key in all vision changes with carotid disease is that it is monocular, a point missed by most practitioners. If a symptom affects both eyes, not carotid! ...Read more
Yes, generally: Ultrasound is the best screening tool for carotid disease. It is non-invasive and gives flow data in real time. Carotid ultrasound is advised for people with multiple risk factors (age over 65, high blood pressure, high cholesterol, diabetes, strong family history, smoking), people with symptoms of stroke or an abnormal noise (bruit) in the neck on exam. ...Read more
Possibly: If you develop transient visual disturbance like curtain coming down your eye, it may well be early sign of carotid disease so see your doc soon. ...Read more
Doctors please advise. Is it ok to press your carotid to ck pulse if you have carotid artery disease?
Ok but: There is truly no association between pressing on the carotid artery and increase risk of stroke in my opinion except if the patient has more than fifty percent stenosis and he is symptomatic because in this special situation the plaque in the carotid artery can be friable and pressing on it can cause another attack. ...Read more
Multiple modalities: Carotid ultrasound is the least invasive of the tests. Mr angiography requires a patient to lie in a confined space. The quality of the images is dependent upon no movement during the study. Ct angiography requires iodine-based contrast dye. Patients with chronic renal disease may have special preparations before their study. The gold standard is most invasive, arterial angiography. ...Read more
Ischemic stroke: Carotid artery disease usually occurs at the origin of the internal carotid artery at the neck and results from plaque build up. The main concern is that blood clots may for from turbulent blood flow this plaque causes, and the clot may travel upward and block an important brain artery, causing a stroke. It is a common found and commonly treated cause for stroke. Several options exist. ...Read more
NO.: The carotid artery in the neck forks into two branches at the ear level. Just as in a river fork, flow at the fork is turbulent. This turbulence is what some people hear, even though there may be no narrowing in the artery. Next time you see your doctor have him/her listen over the carotid artery. If there is a bruit (swishing noise) there, an ultrasound study should be obtained. ...Read more
Should I be concerned with a new side effect of carotid artery disease? I have been suffering from carotid artery disease, however recently I started seeing black spots. I know that this is a side effect, but should I be concerned of this sudden appearanc
Yes: Yes, you should be concerned as you may have an ulcerated plaque or an irrregular lining to your carotid vessels that supply the brain. If a piece breaks off and goes through your neck into your ophthalmic artery the blood supply to your eye it could be causing these black spots. I would see medical consultation immediately. Your body could be warning you that a stroke is coming. ...Read more
Carotid stenosis: In the carotid arteries the flow of blood goes from being linear to being turbulent due to the "fork in the road" at the bifurcation. This causes the area of the proximal internal and external carotid arteries to develop plaque. This plaque leads to narrowing of the artery. The material that is causing the narrowing is fragile and can break off and cause a stroke. ...Read more
Risk of stroke: Carotid disease is a risk factor for stroke. Prior to a stroke, a patient may have transient ischemic attacks (tias), which are brief episodes of weakness or numbness on one side of the body, coordination or speech difficulties. A specific TIA attributable to carotid disease is a brief loss of vision in one eye called amaurosis fugax. Treatment of asymptomatic carotid disease is controversial. ...Read more
Why would I be given Clopidogrel (Plavix (clopidogrel)) for TIA when Warafin is reversible? Is Warafin Not indicated in in TIA for Carotid Artery Disease?
Differences: Clopidigrel has been carefully studied for prevention of stroke and heart attack, and seems to work well for local obstruction of blood vessels, but warfarin is an anti-coagulant designed to prevent blood clots at a distance from entering the brain circulation. Warfarin does not seem to be risk advantageous for local TIA, and likely your doctor has made a reasonable choice. ...Read more
Early: Detection of carotid artery disease.Get a more detailed answer ›
Carotid artery disease, different results from duplex ultrasound vs. Ct angiogram (cta), is that possible?
No: Using medications like anti hypercholesterol like Lipitor (atorvastatin) binging bad cholesterol or LDL to below 100 showed in some study that it can prevent progression of atherosclerosis and narrowing in carotid arteries. In minority of patients it shows very slow regression or decrease in size but not significant. If u have symptoms and more than 50% stenosis then surgery is the answer. ...Read more
Endarterectomy: This is an operation that removes the plaque from the lumen of the artery. Traditionally this is the gold standard treatment for carotid disease. In some patients however that are high risk for surgery your doctor may recommend carotid stenting. Either way maximal medical management of peripheral vascular disease should be incorporated into the treatment paradigm. ...Read more