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Question:

Is it common to have carotid artery disease without heart disease?

I am a 45 year old female with lots of young heart disease in my family history. I went through some test and found that I have carotid artery disease. My stress test and my ultrasound of the heart came back looking good. My carotid artery blockage was in the 50-79 category. My question is - I had thought that heart disease came first then carotid artery disease. Should I be concerned and go ahead and have a heart cath to be 100% sure that there is no heart blockage? I still am experiencing heart palpitations from time to time. My dad had his first open heart surgery when he was 51; his dad died at 47 from heart attack; uncles and aunts all died premature from heart. See where my concern is? Is it common to have carotid artery disease and no heart trouble? Thank you. 

submitted by Diana from Michigan, on 11/5/09Ask a Texas Heart Institute Doctor

Answer:

by Texas Heart Institute cardiologist, Atasu K. Nayak, MD

Thanks for your question. There is increased incidence of coronary artery disease in people who have peripheral vascular disease such as carotid artery disease. Because your stress test and echocardiogram are normal, you need to modify your risk factors such as high cholesterol, blood pressure and diabetes if you have any of those conditions. You do not need a coronary angiogram unless you have an abnormal stress test or any symptoms like chest pain or shortness of breath. You also need serial ultrasonograms of the carotid arteries for progression or stabilization of stenosis. Carotid revascularization is done if you have asymptomatic >80% stenosis or symptomatic >60% stenosis. You should consult a cardiologist/vascular medicine specialist/neurologist for this problem. 

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Updated November 2009
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