artery on one side

Overview

Carotid artery disease is a condition where one of the main arteries in your neck that carries blood to your brain becomes narrowed or blocked on one side. This narrowing is usually caused by a buildup of fatty deposits called plaque. It is sometimes called carotid stenosis.

Carotid artery disease is fairly common, especially in people over 50. It is one of the main causes of stroke in the UK and worldwide.

It mainly affects older adults, particularly those with high blood pressure, high cholesterol, diabetes, or a history of smoking. It is also more common in men and in people with a family history of stroke or heart disease.

Symptoms

Common symptoms

• Most people with carotid artery disease have no symptoms at all until a stroke or TIA occurs.
• Some people may hear a whooshing sound in their ear on the affected side (called pulsatile tinnitus).
• A TIA can cause temporary symptoms such as weakness or numbness on one side of the body, trouble speaking, or vision loss in one eye.

Symptoms in children

• Carotid artery disease is very rare in children. When it does occur, it is usually due to a different cause, such as a genetic condition or inflammation of the arteries.

Symptoms in older adults

• Older adults may have more difficulty recovering from a stroke caused by carotid artery disease.
• They are more likely to have other underlying health conditions that affect the arteries, such as high blood pressure and diabetes.

Causes

Main causes

• Atherosclerosis – a buildup of cholesterol, fat, and other substances (plaque) inside the artery wall.
• Injury to the carotid artery, such as from a neck trauma or dissection (a tear in the artery lining).
• Inflammation of the arteries (arteritis) from conditions like giant cell arteritis.

Risk factors

• High blood pressure (hypertension).
• High cholesterol.
• Smoking or tobacco use.
• Diabetes.
• Obesity and lack of physical activity.
• Unhealthy diet high in saturated fats and salt.
• Family history of stroke or heart disease.
• Age (over 50) and being male.

When to see a doctor

See a doctor urgently if:

• If you have any symptoms of a TIA or stroke – call your local emergency number immediately.
• If you suddenly hear a whooshing sound in your ear that lasts more than a few hours.

Book a routine appointment if:

• If you are over 50 and have risk factors like high blood pressure, diabetes, or smoking, ask your GP about a check-up for your arteries.
• If you have a family history of stroke or carotid artery disease.

Diagnosis

Your doctor will first listen to the artery in your neck with a stethoscope – a whooshing sound (bruit) may suggest narrowing. The main test is a carotid ultrasound, which uses sound waves to see the blood flow and measure how narrow the artery is.

Tests that may be done

• Carotid ultrasound (Doppler ultrasound).
• CT angiography or magnetic resonance angiography (CTA or MRA) – these are special scans that give a detailed picture of the artery.
• Blood tests to check cholesterol, blood sugar, and other risk factors.

What to expect at your appointment

The tests are painless and non-invasive (except for a blood draw). Usually, you will have an ultrasound scan that takes about 30 minutes. After that, your doctor will explain the results and what they mean for your health.

Treatment

Treatment aims to prevent a stroke by slowing the buildup of plaque and managing risk factors. It may involve lifestyle changes, medications, and in some cases a procedure to open the artery.

Self-care at home

• Stop smoking – ask your GP about support programs.
• Eat a heart-healthy diet low in saturated fats, salt, and sugar.
• Get regular physical activity – at least 150 minutes of moderate exercise per week, as advised by your doctor.
• Maintain a healthy weight.
• Limit alcohol intake.

Medical treatments

Your doctor may recommend medicines to lower blood pressure, reduce cholesterol, and prevent blood clots. (No specific drug names are given here – follow your doctor's prescription exactly.) These medicines help slow the disease and reduce your stroke risk.

When is surgery considered?

If the narrowing is severe (usually more than 70%) or if you have had a TIA or stroke, your doctor may suggest a procedure called carotid endarterectomy – a surgery to remove the plaque. Alternatively, a stent may be placed to widen the artery (carotid artery stenting). Your doctor will discuss the risks and benefits based on your individual situation.

Living with this condition

Living with carotid artery disease means managing your risk factors every day. Take your medicines as prescribed, attend regular check-ups, and be aware of stroke symptoms. Many people live full lives with this condition by making healthy choices.

Lifestyle tips

• Take all prescribed medicines consistently.
• Monitor your blood pressure at home if recommended by your doctor.
• Avoid smoking and secondhand smoke.
• Manage stress with relaxation techniques or hobbies.

Diet and exercise

Follow a heart-healthy diet: plenty of fruits, vegetables, whole grains, lean proteins (like fish and poultry), and healthy fats (like olive oil and nuts). Limit red meat, processed foods, and sugary drinks. Aim for at least 30 minutes of moderate exercise most days – walking, swimming, or cycling are good options. Always check with your doctor before starting a new exercise program.

Mental health and emotional wellbeing

Being diagnosed with a condition that increases your stroke risk can cause anxiety or depression. It is normal to feel worried. Talk to your doctor or a counsellor, and connect with family and friends for support.

Prevention

You cannot always prevent carotid artery disease, but you can significantly reduce your risk by adopting a healthy lifestyle early. Keeping your blood pressure and cholesterol in check, not smoking, and staying active are the most important steps.

Vaccines

No specific vaccines prevent carotid artery disease, but staying up to date with flu and pneumonia vaccines can help avoid infections that might stress your heart and circulation.

Screening programmes

Routine screening is not recommended for everyone, but if you have multiple risk factors or a family history of stroke, your doctor may suggest a carotid ultrasound.

Complications

If left untreated

• Stroke – a blockage or clot from the narrowed artery can travel to the brain, causing permanent brain damage.
• Transient ischemic attack (TIA) – temporary stroke-like symptoms that are a warning sign of a future stroke.
• Progressive narrowing that eventually blocks the artery completely.

Long-term outlook

With proper treatment and lifestyle changes, the risk of stroke can be greatly reduced. Many people with carotid artery disease live long, active lives. The key is to work closely with your healthcare team and stay on top of your health. Even if you have had a stroke, rehabilitation and support can help you recover and maintain a good quality of life.

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