Carotid artery pain stems from three known conditions, two of which are related to cholesterol deposits. When plaque blocks blood flow to the brain, it causes carotid artery disease. Arteriosclerosis can also cause pain in the carotid artery when the walls of the arteries thicken or harden, hindering the flow of oxygen-rich blood to the brain and other vital organs. Carotidynia is a common source of pain with no known cause, and it can appear as a throbbing or dull pain that increases when palpated.
Visible pulsations WebMD Symptom Checker helps you find the most common symptom combinations and medical conditions related to visible pulsations. Click on the combination that matches your symptoms to find the conditions that may cause these problems. Checking pulse over the carotid artery. To check your pulse over your carotid artery, place your index and middle fingers on your neck to the side of your windpipe. When you feel your pulse, look at your watch and count the number of beats in 15 seconds. Multiply this number by 4 to get your heart rate per minute. The carotid artery can be positioned close to the surface in some individuals. If a person doesnt have extensive fat tissue, and if the neck is held in certain positions its very easy to see the pulsations. Its just a variation of normal in almost all cases, with the rare rare exception of an aneurysm.
High blood pressure, diabetes, smoking, and a diet high in fatty foods might lead to carotid artery pain. Obesity, lack of exercise, and a family history of carotid artery disease might also contribute to the problem. Carotid artery stenosis means that the arteries have become blocked by cholesterol deposits, also called hardening of the arteries. If these vessels become completely blocked, it could cause a stroke and permanent brain damage within three to six hours.
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Strokes might also occur if an artery ruptures or if plaque breaks loose and enters a smaller artery in the brain. Blood clots also might cause pain in the carotid arteries. These arteries transport blood to the front part of the brain, which controls personality, speech, motor skills, and sensory perception.
Pulsations and bounding heartbeat felt throughout my body 24/7, particularly in head/face/neck/occipitals/upper back. Affects my balance when seated, and is. In the neck your artery is located fairly deep under the tissus.If you are relatively thin, the pulse may be barely visible when you are at rest. The Veins which return blood to the heart are more superficial and some lie just beneath the skin. These vessels may be very visible as one ages and the skin sags a little. Veins do not have a pulse.
Arteriosclerosis is diagnosed when arterial walls lose elasticity and become thick or hardened. This disorder may stem from the same lifestyle and dietary habits as carotid artery disease, along with stress. If the organs are deprived of oxygen, paralysis and memory loss can follow. Symptoms of arteriosclerosis include pain, numbness, and dizziness.
Carotidynia can provoke pain in the face, neck, ear, or head that may increase when a person is swallowing or chewing food. Its cause is unknown, but the condition occurs more often in women. Carotid artery pain from this disorder might disappear on its own without treatment.
The carotid arteries are found on each side of the neck, and they can be located by feeling for a pulse as the heart pumps blood to the brain. Pain in these arteries is commonly felt along the neck and in the face. If the pain persists, it might signal the need for anti-inflammatory medication.
Treatment generally involves medication that prevents blood from clotting too much. These drugs might be effective when less than 50% of an artery is blocked. When more than half of the artery is obstructed, surgery may be required.
After you measure the JVP, move on to assessment of the carotid pulse. The carotid pulse provides valuable information about cardiac function and is especially useful for detecting stenosis or insufficiency of the aortic valve. Take the time to assess the quality of the carotid upstroke, its amplitude and contour, and presence or absence of any overlying thrills or bruits.
For irregular rhythms, see Table 3-10, Selected Heart Rates and Rhythms (p._), and Table 3-4,
Selected Irregular Rhythms (p._).
To assess amplitude and contour, the patient should be lying down with the head of the bed still elevated to about 30°. When feeling for the carotid artery, first inspect the neck for carotid pulsations. These may be visible just medial to the sternomastoid muscles. Then place your left index and middle fingers (or left thumb11) on the right carotid artery in the lower third of the neck, press posteriorly, and feel for pulsations.
A tortuous and kinked carotid artery may produce a unilateral pulsatile bulge.
J^ll Although there is a widespread prejudice against using thumbs to assess pulses, they are useful for palpating large arteries.
Decreased pulsations may be caused by decreased stroke volume, but may also be due to local factors in the artery such as atherosclerotic narrowing or occlusion.
J^ll Although there is a widespread prejudice against using thumbs to assess pulses, they are useful for palpating large arteries.
Press just inside the medial border of a well-relaxed sternomastoid muscle, roughly at the level of the cricoid cartilage. Avoid pressing on the carotid sinus, which lies at the level of the top of the thyroid cartilage. For the left carotid artery, use your right fingers or thumb. Never press both carotids at the same time. This may decrease blood flow to the brain and induce syncope.
Slowly increase pressure until you feel a maximal pulsation, then slowly decrease pressure until you best sense the arterial pressure and contour. Try to assess:
Pressure on the carotid sinus may cause a reflex drop in pulse rate or blood pressure.
See Table 3-9, Abnormalities of the Arterial Pulse and Pressure Waves (p. __).
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■ The amplitude of the pulse. This correlates reasonably well with the pulse pressure.
■ The contour of the pulse wave, namely the speed of the upstroke, the duration of its summit, and the speed of the downstroke. The normal upstroke is brisk. It is smooth, rapid, and follows S1 almost immediately. The summit is smooth, rounded, and roughly midsystolic. The downstroke is less abrupt than the upstroke.
■ Any variations in amplitude, either from beat to beat or with respiration.
Thrills and Bruits. During palpation of the carotid artery, you may detect humming vibrations, or thrills, that feel like the throat of a purring cat. Routinely, but especially in the presence of a thrill, you should listen over both carotid arteries with the diaphragm of your stethoscope for a bruit, a murmur-like sound of vascular rather than cardiac origin.
You should also listen for bruits over the carotid arteries if the patient is middle-aged or elderly or if you suspect cerebrovascular disease. Ask the patient to hold breathing for a moment so that breath sounds do not obscure the vascular sound. Heart sounds alone do not constitute a bruit.
Further examination of arterial pulses is described in Chapter 14, The Peripheral Vascular System.
The Brachial Artery. The carotid arteries reflect aortic pulsations more accurately, but in patients with carotid obstruction, kinking, or thrills, they are unsuitable. If so, assess the pulse in the brachial artery, applying e techniques described above for etermining amplitude and contour.
se the index and middle fingers or humb of your opposite hand. Cup
Small, thready, or weak pulse in cardiogenic shock; bounding pulse in aortic insufficiency (see p._).
Delayed carotid upstroke in aortic stenosis
Pulsus alternans, bigeminal pulse (beat-to-beat variation); paradoxical pulse (respiratory variation)
A carotid bruit with or without a thrill in a middle-aged or older person suggests but does not prove arterial narrowing. An aortic murmur may radiate to the carotid artery and sound like a bruit.
your hand under the patient's elbow and feel for the pulse just medial to the biceps tendon. The patient's arm should rest with the elbow extended, palm up. With your free hand, you may need to flex the elbow to a varying degree to get optimal muscular relaxation.
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