A short story: what would you do?
Follow Tito Eddie to learn the warning signs and what to do. Turn on your sound for the narration.
What happens in carotid artery disease
You have two carotid arteries, one on each side of your neck. They carry blood to your brain and eyes. [Ref: ESVS 2023 Carotid]
Fatty plaque builds up inside the carotid artery, most often where it splits into two branches. This narrowing is called carotid stenosis. A piece of plaque, or a clot that forms on it, can break off and travel to the brain. There it blocks a small artery and causes a stroke, or a short-lived mini-stroke called a transient ischaemic attack (TIA). [Ref: ESVS 2023 Carotid]
With symptoms (symptomatic)
You had a stroke, a TIA or sudden vision loss in one eye on the same side as the narrowing in the past 6 months. The risk of another stroke is highest in the first days and weeks, so you need urgent care.
Without symptoms (asymptomatic)
The narrowing was found on a scan, but you have had no stroke symptoms. The stroke risk is lower. Medicines and healthy habits are the main treatment.
[Ref: ESVS 2023 Carotid]
Why it matters
Stroke is the third leading cause of death in the Philippines, causing about 56,000 deaths from January to November 2025. [Data: PSA 2025]
Worldwide, about 1 to 2 in 100 adults have a carotid artery narrowed by half or more without knowing it. It is more common with older age, in men, and in people who smoke or have diabetes, high blood pressure, high cholesterol, or disease of the heart or leg arteries. [Ref: ESVS 2023 Carotid]
Warning signs
Most people with carotid narrowing have no symptoms until a TIA or stroke. These signs come on suddenly, usually on one side of the body: [Ref: ESVS 2023 Carotid]
Weakness or numbnessOf the face, arm or leg, on one side. The arm or leg may feel clumsy.
Trouble speakingSlurred speech, or trouble finding words, understanding or writing.
Vision loss in one eyeSudden blurring or loss of sight in one eye, often like a curtain coming down (amaurosis fugax).
Signs that go awayIf the signs pass within minutes or hours, it may be a TIA. It is still an emergency.
Why a TIA is urgent
In studies, up to 1 in 5 people had a stroke within a week of a TIA. Going to the emergency room right away, and getting treatment within days, prevents many of these strokes. [Ref: ESVS 2023 Carotid]
Dizziness alone, fainting, or double vision alone are usually not caused by carotid narrowing. But sudden double vision, sudden trouble walking or sudden severe dizziness can still be a stroke in the back of the brain. Go to the emergency room now. Dizziness when turning the head should not be blamed on the neck arteries unless a scan shows a problem. [Ref: ESVS 2023 Carotid]
What happens at your check-up
The main test is a carotid duplex ultrasound. It is painless and shows how narrow the artery is. A CT or MR angiogram may be added to plan treatment. A catheter angiogram is rarely needed. After a TIA or stroke, a brain scan (CT or MRI) is also done. [Ref: ESVS 2023 Carotid]
Screening everyone is not recommended. A scan may be considered if you have two or more risk factors, mainly to make sure your medicines are right. [Ref: ESVS 2023 Carotid]
Your doctor decides which tests you need and explains what the results mean for you.
Worried about stroke? Get your arteries checked.
Only an examination and an ultrasound can tell whether your carotid arteries are narrowed and which treatment is right for you. Dr. Aaron Christopher P. Novales sees patients with carotid artery disease.
Face drooping, arm weakness or trouble speaking? Do not wait for a clinic visit. Go to the emergency room now →
How it is treated
About the medicines on this page
Medicines are described here only to help you understand your doctor's plan. Do not buy or take any medicine because you read about it here. Take only what your doctor prescribes for you, and never start, stop or change a dose on your own.
Healthy habits
Stop smoking, eat a healthy diet and be physically active. These are recommended for everyone with carotid narrowing. [Ref: ESVS 2023 Carotid]
Medicines
Cholesterol-lowering medicine: lowers the risk of stroke and heart attack. Your doctor chooses the medicine and the dose.
Blood pressure medicines: if you have high blood pressure.
Antiplatelet medicine: helps prevent clots. Your doctor will choose which one, and for how long.
Diabetes control: if you have diabetes.
[Ref: ESVS 2023 Carotid]
Procedures to open the artery
Some people also need a procedure. Carotid endarterectomy is surgery through a cut in the neck to remove the plaque. Carotid stenting places a small mesh tube inside the artery through a thin catheter. [Ref: ESVS 2023 Carotid]
Whether you need a procedure depends on how narrow the artery is, whether you have had symptoms, and your overall health. If you have had a stroke or mini-stroke, see your doctor urgently, because a procedure, when needed, works best within days.
Your doctor and a vascular team will help you choose between surgery and stenting. [Ref: ESVS 2023 Carotid]
After a procedure
You will keep taking the medicines your doctor prescribes, usually long term. Follow-up ultrasound checks are planned with your doctor. [Ref: ESVS 2023 Carotid]
Daily self-care
Take your medicines every dayEven when you feel well. Ask before stopping any of them.
Check your blood pressureKeep it at the target your doctor sets.
Do not smokeStopping smoking lowers the risk of stroke and heart attack.
Know the warning signsTeach your family BE FAST, and go to the emergency room right away if signs appear.
[Ref: ESVS 2023 Carotid] [Ref: AHA/ASA Stroke Warning Signs]
Talk to your doctor about
Bring these questions to your visit.
- How narrow is my carotid artery, and on which side?
- Are my symptoms related to the narrowing?
- Am I on the right medicines?
- Would endarterectomy or stenting help me, and what are the risks?
- How often should my arteries be checked?
Related conditions
Guideline sources for this page
- ESVS 2023 Carotid: Naylor R, Rantner B, et al. European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease. Eur J Vasc Endovasc Surg 2023;65:7–111.
- AHA/ASA Stroke Warning Signs: American Stroke Association. Stroke symptoms and warning signs (F.A.S.T. and other sudden signs).
- PSA 2025: Philippine Statistics Authority, provisional causes of death, January to November 2025, as reported by GMA News (28 May 2026).