The carotid arteries are a pair of large blood vessels on either side of the neck that deliver oxygen-rich blood directly to the brain. Carotid Artery Disease (CAD) occurs when these vessels become narrowed or blocked by a buildup of fatty deposits, known as plaque. This process, called atherosclerosis, restricts blood flow to the brain and increases the risk of a stroke. Although concern about feeling the blockage is common, the condition is often “silent” in its early stages.
Can You Physically Feel the Blockage?
People generally cannot feel the physical buildup of plaque inside the carotid artery. Atherosclerosis is a gradual process where cholesterol and other materials accumulate deep within the artery wall. Since the artery wall does not contain sensory nerves to register this internal plaque growth, the blockage does not cause neck pain or a palpable sensation of pressure.
A person can feel their normal carotid pulse, but this only confirms blood flow, not whether the vessel is narrowed. In rare cases, a healthcare provider might listen to the neck with a stethoscope and detect an abnormal sound called a “bruit.” This subtle whooshing noise is caused by turbulent blood flow past a severe narrowing. However, this sound is an auditory sign for a doctor, not a physical sensation felt by the patient. The absence of a bruit does not mean the arteries are clear, as many significant blockages do not produce this sound.
Recognizing Warning Signs of Restricted Blood Flow
Symptoms of Carotid Artery Disease only become noticeable when blood flow to the brain is severely reduced or when a piece of plaque breaks off. These events lead to a Transient Ischemic Attack (TIA) or a full stroke. The resulting symptoms are neurological, not pain-related in the neck. A TIA, often called a “mini-stroke,” is a temporary blockage that serves as a warning sign of future stroke risk.
These neurological warning signs often manifest suddenly and affect one side of the body. Common symptoms include sudden weakness or numbness of the face, arm, or leg. The affected person may have trouble lifting one arm or experience facial drooping on one side.
Speech difficulties are a frequent sign, presenting as slurred speech or an inability to find words or understand what others are saying. Vision changes can also occur suddenly, such as blurred vision or a temporary loss of sight in one eye (amaurosis fugax). A person may also experience sudden dizziness, a loss of balance, or difficulty walking.
How Doctors Confirm Carotid Artery Blockage
The initial step in diagnosing Carotid Artery Disease is often a non-invasive procedure called a Carotid Ultrasound, or carotid duplex. This painless test uses high-frequency sound waves to create an image of the arteries. It employs Doppler technology to measure the speed and direction of blood flow. The ultrasound detects plaque presence and accurately estimates the degree of narrowing by measuring the peak systolic velocity of the blood.
If ultrasound results are inconclusive or if a more detailed assessment is needed before surgical planning, advanced imaging techniques are used. These include Computed Tomography Angiography (CTA) and Magnetic Resonance Angiography (MRA). A CTA uses X-rays and an injected contrast dye to provide a swift, detailed view of the vessel lumen and the surrounding plaque.
MRA uses magnetic fields and radio waves, sometimes with a contrast agent, to produce high-resolution images of the blood vessels. While CTA is fast and useful for viewing vessel calcification, MRA is often superior for characterizing the plaque itself, such as detecting signs of intraplaque hemorrhage. These modalities help doctors determine the stability of the plaque and the best course of treatment.
Immediate Action and Risk Reduction
If any neurological warning signs occur, even if temporary, immediate emergency medical attention is necessary. The most effective way to remember these signs is by using the F.A.S.T. acronym: F for Facial drooping, A for Arm weakness, S for Speech difficulty, and T for Time to call emergency services.
Noting the exact time the symptoms began is crucial information for medical responders, as quick intervention can minimize long-term damage. For long-term risk reduction, controlling underlying health conditions is necessary to slow the progression of atherosclerosis. This involves managing high blood pressure and elevated cholesterol levels through medication and diet changes. Quitting smoking and engaging in regular physical exercise are also important steps.