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Suggest Treatment For Mild Carotid Artery Stenosis

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Posted on Thu, 28 Jan 2016
Question: I have a mildly occluded right carotid artery, found in a preventive scan a couple years ago. No symptoms yet. Wondering on natural cures dietary methods to "clean" arteries?
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would like to explain that your right carotid artery stenosis is quite mild and clinically non significant(PSV less than, 110cm/sec).

From the other side, it is necessary to avoid atherosclerotic plaques progression and what is more important, preventing embolic cerebral events.

Though you are not yet convinced about antilipemiant therapy, I strongly recommend starting one of statins (especially facing your increased BMI and blood lipid profile.

In addition, decreasing your body weight ( through a healthy diet and daily physical activity, at least 4 km walking daily).

Also avoiding close smoking contact, frequently monitoring blood pressure values and possible glucose metabolism abnormalities are valuable measures in this regard.

If no contraindications exist, daily intake of aspirin in small doses (80-100mg) would help you prevent possible transient ischemic attacks.

Hope to have been helpful!

Feel free to ask me whenever you need!

Kind regards,
Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (3 hours later)
Thanks for the information on the right carotid artery. I will print this out and try to follow it. I uploaded two more reports for my free follow up questions. First, my recent lipids test. Question: with cholesterol in normal range, the nurse still recommended statin or reducing medication. She said stroke risk of 7.8% which should below 7.5%. So meds because of a .3% higher risk? She is not a cardiologist and I question this Thoughts?

Next, I have had Vitamin D deficiency found in my physicals over the last 7-8 years. Is this chronic? What are hazards? I do take D supplements a couple times per week. Should I take the 50,000 dose she recommends? Regards,
XXXXXXX Walsh
doctor
Answered by Dr. Ilir Sharka (5 hours later)
Brief Answer:
Opinion as follows:

Detailed Answer:
Hi again XXXXXXX

I reviewed you uploaded blood lipid profile and vitamin D reports.

I could say that your blood lipid profile seems to be favorable with a satisfactory level of total cholesterol, LDL cholesterol and triglycerides.

Your HDL cholesterol which is considered in fact the “good, protective” cholesterol portion needs to be a bit higher (>50 mg/dl, preferably >60 mg/dl).

This could be achieved by decreasing your body weight and especially by following a daily physically active profile (as I mentioned above).

My opinion would be to try those preventive measures first for about three months.

A healthy diet (poor in fatty components, avoiding spicy foods and saturated fats) would be necessary.

I recommend Mediterranean diet with a balanced ratio of the required components.

If after 3 months we have not a more improved blood lipid profile, I recommend to star a low dose of any statins (Atorvastatin for example 10 mg/daily).

Regarding your vitamin D level, I could say that a 19 ng/ml needs therapy for sure.

Though you are clinically asymptomatic (subclinical deficiency), it is necessary to take vitamin D supplement in order to prevent decreased blood levels of calcium and phosphate and its adverse consequences on musculoskeletal system, preventing thus decreased bone density, osteomalacia, possible bone fractures, elevated secondary parathyroid hormone values, cardiovascular [cardiomyopathy, possible arrhythmias], immune processes, etc.

If vitamin D level is less than 20 ng/ml (such as your case), it is necessary 50000 IU vitamin D2 or D3 by mouth at least once per week for 6 – 8 weeks and then 800 – 1000 IU vitamin D3 daily.

Remember that in addition 1000 mg calcium daily and possibly vitamin K2 are necessary for an optimal utilization of Vitamin D supplement.

But, you need to discuss with your prescribing doctor about the ongoing scheme.

Let me know how things are going on.

Wishing you all the best!

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (20 hours later)
Thank you kindly. The problem with medical assistance for insurance is that I haven't seen a doctor yet. Managed care I guess. So this definitely has value.

Happy New Year,
XXXXXXX Walsh
doctor
Answered by Dr. Ilir Sharka (8 hours later)
Brief Answer:
You are welcome!

Detailed Answer:
Dear XXXXXXX

I am glad to have been helpful!

If you have any other uncertainties, you can ask me directly at any time at the link below:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Happy new Year to you!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9180 Questions

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Suggest Treatment For Mild Carotid Artery Stenosis

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would like to explain that your right carotid artery stenosis is quite mild and clinically non significant(PSV less than, 110cm/sec). From the other side, it is necessary to avoid atherosclerotic plaques progression and what is more important, preventing embolic cerebral events. Though you are not yet convinced about antilipemiant therapy, I strongly recommend starting one of statins (especially facing your increased BMI and blood lipid profile. In addition, decreasing your body weight ( through a healthy diet and daily physical activity, at least 4 km walking daily). Also avoiding close smoking contact, frequently monitoring blood pressure values and possible glucose metabolism abnormalities are valuable measures in this regard. If no contraindications exist, daily intake of aspirin in small doses (80-100mg) would help you prevent possible transient ischemic attacks. Hope to have been helpful! Feel free to ask me whenever you need! Kind regards, Dr. Iliri