Q. My doctor put his stethoscope on my neck and muttered to himself, “no brooey.” I’m not the type to ask the doctor questions, but I’m still wondering what he meant by that. My spelling is probably wrong.
A. Your doctor was checking your carotid arteries on the sides of your neck to see if the blood flow to your brain was blocked. If one of the arteries was blocked, it would make a “swoosh” that the medical profession calls a bruit. Your phonetic spelling is excellent. Bruit is pronounced “BROO-ee,” like “phooey.”
Carotid arteries run from the aorta — the main trunk of the arterial system — up to your brain. When these vessels become blocked, you have carotid artery disease, which can cause a stroke.
The chances of developing this disease increase with age. About one percent of people in their fifties have significantly blocked carotid arteries, but ten percent of people in their eighties have carotid artery disease.
As you age, a sticky substance called plaque, which contains cholesterol, can accumulate on the inside walls of your arteries. The process is called atherosclerosis, or hardening of the arteries.
Some of the causes of carotid artery disease are high blood pressure, cholesterol in your blood, smoking and diabetes.
It is possible to fight carotid artery disease. First, quit smoking. This is the probably the most significant thing you can do to combat this disease. In addition to quitting smoking, you should get regular exercise, eat a healthy diet and keep your weight down. Obviously, if you have high blood pressure, too much cholesterol in your blood or diabetes, you should be treating those.
The common diagnostic tests for carotid artery disease are: carotid duplex scan, an ultrasound study that shows the location and size of the problem; arteriogram, which is an X-ray, and computerized tomography (CT Scan) of the brain for damage.
The amount of blockage in a carotid artery determines the risk of having a stroke. If the blockage becomes severe enough, you may need surgery to open the blood flow to your brain.
In a carotid endarterectomy, a surgeon makes an incision in the neck to open a carotid artery. The blockage is removed and the artery is closed.
Carotid artery stenting is a procedure in which a wire mesh tube called a stent is positioned and expanded across the blockage in the artery.
In its early stages, carotid artery disease may have no symptoms. The initial indication could be a stroke. However, you may experience warning symptoms of a stroke called transient ischemic attacks, or TIAs, which usually last less than an hour.
TIA symptoms include: weakness, numbness, or a tingling on one side of your body; inability to control a limb; loss of vision in one eye; and inability to speak clearly.
If you experience TIA symptoms, contact your physician immediately.