Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Carotid Bruit

Forum: The Heart Forum
Topic: Heart Disease


Dear Doctors,
I am a 58 year old female diabetic with history of CHF, heart attack,
in Jan. ' 98 and triple by pass surgery in Jan. 1998. Back in 1993 while on vacation at an amusement park I receieve quite a strong whipping of my neck in a rocking bouncing seat. After that I started to experince a noise of heartbeat in my right ear. I informed my doctor and he ordered a Echo of the carotid artery. The results showed a slight blockage about 30%, At that time he said it was nothing to worry about. I had another echo done last week and got the results this morning. The nurse said it was under 50% but didn't give and exact number, but they are not going to treat it yet.. At what point do they do a procedure on it? Also is there anything I can do to slow this down so it doesn't get any worse quickly? In 6 years it has gotten worse, but can you give me an idea of how fast this will progress?
I try to take good care of myself with diet, excercise and various medications. I no longer have the noise in my ear that I had 6 years ago. Is that a good sign or not?
Marlene I


Dear Marlene

First of all, I doubt the noise in your ear had anything to do with the carotid artery.

Medications like aspirin and cholesterol lowering medications are useful to prevent progression of carotid artery disease. You should talk to your doctor about being on these medications, if you are not already.

No one can predict how quickly the carotid artery narrowing will progress, or whether it will progress at all. It was sort of an accident that it was discovered in the first place. No one will think of operating on you until the blockage is at least 70%. However, if you start having symptoms of stroke or mini-stroke, then you may need surgery sooner. There is a newer procedure, called carotid artery stenting, that is being investigated as a less invasive alternative to surgery.

I hope this has been useful. I wish you the best of luck. Feel free to write back.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

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