Curriculum · Cardiovascular and Hypertension
Carotid artery stenosis
What it is
Carotid artery stenosis is important for what comes out of it. In the etiology of stroke it sits under the embolic type: an embolus from another part of the body obstructs a vessel and can affect multiple vascular territories, and the named examples are atrial fibrillation, carotid artery stenosis, and DVT with patent foramen ovale. So the carotid is one site an embolus starts from, and treatment of conditions that raise risk, such as atrial fibrillation and carotid artery stenosis, is part of how the risk of stroke is reduced.
Causes and risk
Carotid atherosclerosis, heard as a bruit, is set beside the embolic type of ischemic stroke, with a history of cardiac disease such as atrial fibrillation or endocarditis, and carotid stenosis is named under embolus. The atherosclerotic risk factors of uncontrolled hypertension and diabetes belong to the thrombotic type instead, together with CAD/PVD, atherosclerosis and HTN. Fibromuscular dysplasia is another cause given, and in adults 90% are women. It gives internal carotid artery stenosis with recurrent headache, pulsatile tinnitus, transient ischemic attack and stroke, and it may also give renal artery stenosis with secondary hypertension and flank pain. Physical examination shows a subauricular systolic bruit and an abdominal bruit.