Carotid artery repair refers to a group of surgical and minimally invasive procedures designed to treat carotid artery disease. This condition occurs when the carotid arteries, which are the main blood vessels supplying blood to the brain, become narrowed or blocked by plaque buildup (atherosclerosis).
While carotid artery disease itself doesn’t directly cause sudden cardiac arrest (SCA), it’s a strong indicator of widespread atherosclerosis throughout the body, including in the coronary arteries that supply blood to the heart. Atherosclerosis in the coronary arteries is the most common cause of coronary heart disease, which can lead to SCA.
What Is SCA?
Sudden Cardiac Arrest (SCA) is an abrupt loss of heart function, breathing, and consciousness. It’s caused by an electrical disturbance in the heart that disrupts its pumping action, leading to an immediate cessation of blood flow to the brain and other organs. Without immediate CPR and or AED intervention, SCA is fatal.
SCA differs from other cardiac conditions in the following ways:
- Heart Attack (Myocardial Infarction): A heart attack occurs when blood flow to a part of the heart muscle is blocked, usually by a blood clot in a coronary artery. This blockage damages or kills a portion of the heart muscle. While a heart attack can sometimes trigger SCA, they are distinct events.
A heart attack is a “plumbing problem,” whereas SCA is an “electrical problem.” Someone can have a heart attack without experiencing SCA, and conversely, SCA can occur without a preceding heart attack, though it often results from underlying heart conditions.
- Heart Disease (Cardiovascular Disease): This broad term encompasses various conditions affecting the heart and blood vessels, including coronary artery disease, heart failure, arrhythmias, and valvular heart disease. Heart disease refers to the underlying conditions that can make a person susceptible to events like heart attacks or SCA.
SCA is a potential consequence or manifestation of existing heart disease, rather than being synonymous with heart disease itself. Many people with heart disease never experience SCA, while others with seemingly minor heart issues can be at risk.
Symptoms of a Carotid Artery Disease
There are often no symptoms of carotid artery disease in its early stages. The first sign may be a transient ischemic attack (TIA) or a small stroke, which can progress from there.
- Transient Ischemic Attack (TIA): Often called a “mini-stroke,” a TIA is a temporary episode of stroke-like symptoms that lasts a few minutes to an hour and then resolves. Symptoms include sudden weakness or numbness on one side of the body, difficulty speaking or understanding speech, sudden vision problems in one eye (like a curtain coming down), or sudden dizziness or loss of balance. A TIA is a strong warning sign of an impending stroke.
- Bruits: A doctor may hear a whooshing sound (bruit) through a stethoscope placed over the carotid artery in the neck. This sound indicates turbulent blood flow due to narrowing.
- Stroke: If a carotid artery becomes severely blocked or a piece of plaque breaks off and travels to the brain, it can cause a stroke. Stroke symptoms are similar to TIA symptoms but are persistent and can lead to permanent disability or death.
These include sudden numbness or weakness, especially on one side of the body, sudden confusion or trouble speaking, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and a sudden, severe headache with no known cause.
Here’s how carotid artery repair can indirectly help prevent SCA:
- Addressing a Marker of Systemic Disease: Carotid artery disease serves as a “warning sign” that an individual is at higher risk for other cardiovascular events, including heart attacks and SCA, due to the generalized nature of atherosclerosis. Treating the carotid arteries often prompts a more aggressive approach to managing overall cardiovascular health.
- Reducing Stroke Risk, Which Shares Risk Factors with SCA: The primary goal of carotid artery repair is to prevent stroke by restoring proper blood flow to the brain and removing unstable plaque that could break off and travel to the brain. Many of the risk factors for stroke (high blood pressure, high cholesterol, diabetes, smoking) are also major risk factors for coronary heart disease and SCA. By addressing these shared risk factors, the overall cardiovascular risk is reduced.
- Facilitating Comprehensive Cardiovascular Management: Patients undergoing carotid artery repair are typically evaluated for other cardiovascular conditions. This often leads to the initiation or intensification of treatments for high blood pressure, high cholesterol, and diabetes, as well as recommendations for lifestyle changes (diet, exercise, smoking cessation). These comprehensive measures directly reduce the risk of heart attack and SCA.
Types of Carotid Artery Repair Procedures:
- Carotid Endarterectomy (CEA): This is a traditional surgical procedure where an incision is made in the neck, and the surgeon opens the carotid artery to remove the plaque buildup. The artery is then stitched closed.
- Carotid Artery Stenting (CAS): This is a less invasive procedure where a catheter is threaded through an artery (usually in the groin) up to the carotid artery. A balloon is inflated to open the narrowed artery, and a small mesh tube called a stent is then placed to keep the artery open.
Conclusion
While carotid artery repair directly aims to prevent stroke, its role in identifying and managing underlying systemic atherosclerosis contributes to a broader reduction in cardiovascular risk, including the potential for SCA. By taking this measure, you may prevent being a victim of SCA and receiving CPR, or succumbing to heart disease.
Author: Donna Ryan writes and lives in Tucson, AZ. You can reach her at donnar668@gmail.com.