Carotid artery disease Flashcards
1
Q
What is carotid artery disease?
A
Atherosclerotic plaques in the common and internal carotid artery
2
Q
What are the risk factors for carotid artery disease?
A
- Age > 65y
- Smoking
- Hypertension
- Hypercholestrolaemia
- Obesity
- Diabetes mellitus
- History of cardiovascular disease
- Family history
3
Q
What are the clinical features of carotid artery disease?
A
- Often asymptomatic (especially if unilateral) but can present with: TIA or stroke
- Can present with a carotid bruit
4
Q
What are the differential diagnosis for carotid artery disease?
A
- Carotid dissection
- Fibromuscular dysplasia (hypertrophy of vessel wall)
- Vasculitis (can cause carotid stenosis)
5
Q
What are the investigations for carotid artery disease?
A
- Urgent non-contrast CT to assess stroke
- First line is carotid US doppler with confirmed cases getting a CT angiography
- Bloods: FBC, UEs, clotting, lipid profile, glucose
- ECG to look for arrhythmia
6
Q
What is the acute management?
A
Treatment of stroke.
Ischaemic stroke - If <4.5 hours then aspirin and alteplase.
7
Q
What is the long term management of carotid artery disease
A
- Antiplatelet therapy (aspirin and clopidogrel)
- High dose atorvastatin
- Management of hypertension
- Smoking cessation
- Carotid endarterectomy
8
Q
What is a carotid endarterectomy?
A
Surgery to remove atheroma and associated damaged intima.
9
Q
What are the complications of a carotid endarterectomy
A
- Ischaemic stroke,
- Nerve damage to hypoglossal, glossopharyngeal or vagus nerve
