Dear doctors: I am 84 years old, and I have been diagnosed with a carotid artery bulb. It seems to be growing with time. I have had an ultrasound of the artery, and the only diagnosis is some calcification. I cannot get any answers as to the possible cause and long-term consequences of having this enlarged artery in my neck area. Perhaps you can give me an answer.
J.P.
A "carotid artery bulb" isn't a diagnosis; it's the name of an anatomic structure. Also called the carotid sinus, it is a normal structure in the internal carotid artery (the major artery going to your brain), right where the artery begins.
I suspect the diagnosis is atherosclerosis of the carotid bulb: artery hardening or thickening of the artery walls with cholesterol and calcium. It puts people at higher risk for stroke.
In addition, having atherosclerosis in the carotid bulb tends to mean that the same disease can be found in the arteries of the heart, which increases your risk of heart attack. The most common risk factors for this condition are smoking, high blood pressure, high cholesterol, diabetes and a family history of heart disease.
Fortunately, these risks can be lessened, even in an 84-year-old, with good diet, regular exercise and, in many cases, medication to lower cholesterol. If there is severe blockage in the carotid artery, surgery is occasionally done. Most people with this condition also should be taking Aspirin, unless there is some reason not to. Internists and cardiologists usually manage the medical side of this condition: Surgery, if necessary, is done by a vascular surgeon.
It's also possible that "enlargement" in your case could be an aneurism of the carotid artery at the carotid bulb. This is an abnormal dilatation of the artery caused by weaknesses in the artery wall. Aneurisms are serious, and if very large (or getting larger), often require surgery by a vascular surgeon.
Drs. Donohue and Roach will be co-writing Your Good Health until the end of this year, when Dr. Roach becomes the sole writer. Dr. Donohue is retiring after 30 years of writing this column.
