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Cardiac and vascular imaging specialists on the medical staff of Baylor Scott & White The Heart Hospital – Plano​​ use advanced technologies to diagnose and manage a wide range of cardiac and vascular disorders. Through noninvasive imaging, your physician can see how effectively your heart is pumping or blood is circulating through your arteries and body. Preventive screening and heart tests, such as a carotid ultrasound, allow us to track how you're doing and make a diagnosis.

What is a Carotid Ultrasound?

A carotid ultrasound shows whether a waxy substance called plaque has buildup in your carotid arteries. The buildup of plaque in the carotid arteries is called carotid artery disease.

Carotid artery disease is serious because it can cause a stroke​, also called a "brain attack." A stroke occurs if blood flow to your brain is cut off.

If blood flow is cut off for more than a few minutes, the cells in your brain start to die. This impairs the parts of the body that the brain cells control. A stroke can cause lasting brain damage; long-term disability, such as vision or speech problems or paralysis (an inability to move); or death.


Carotid artery disease is a major cause of stroke in the United States. Over time, plaque hardens and narrows the arteries. This may limit the flow of oxygen-rich blood to your organs and other parts of your body.

Atherosclerosis can affect any artery in the body. For example, if plaque builds up in the coronary (heart) arteries, a heart attack​ can occur. If plague builds up in the carotid arteries, a stroke can occur.

A stroke also can occur if blood clots form in the carotid arteries. This can happen if the plaque in an artery cracks or ruptures. Blood cell fragments called platelets stick to the site of the injury and may clump together to form blood clots. Blood clots can partly or fully block a carotid artery.

A piece of plaque or a blood clot also can break away from the wall of the carotid artery. The plaque or clot can travel through the bloodstream and get stuck in one of the brain's smaller arteries. This can block blood flow in the artery and cause a stroke.

Carotid artery disease may not cause signs or symptoms until the carotid arteries are severely narrowed or blocked. For some people, a stroke is the first sign of the disease.


Carotid artery disease is a major cause of stroke in the United States. Other conditions, such as certain heart problems and bleeding in the brain, also can cause strokes. Lifestyle changes, medicines, and medical procedures can help prevent or treat carotid artery disease and may reduce the risk of stroke.

If you think you're having a stroke, you need urgent treatment. Call 9-1-1 right away if you have symptoms of a stroke. Do not drive yourself to the hospital. You have the best chance for full recovery if treatment to open a blocked artery is given within four hours of symptom onset. The sooner treatment occurs, the better your chances of recovery.

Who Needs a Carotid Ultrasound?

A carotid ultrasound shows whether you have plaque buildup in your carotid arteries. Over time, plaque can harden or rupture (break open). This can reduce or block the flow of oxygen-rich blood to your brain and cause a stroke.

Your doctor may recommend a carotid ultrasound if you:

  • Had a stroke or mini-stroke recently. During a mini-stroke, you may have some or all of the symptoms of a stroke. However, the symptoms usually go away on their own within 24 hours.
  • Have an abnormal sound called a carotid bruit in one of your carotid arteries. Your doctor can hear a carotid bruit using a stethoscope. A bruit might suggest a partial blockage in your carotid artery, which could lead to a stroke.

Your doctor also may recommend a carotid ultrasound if they think you have:

  • Blood clots in one of your carotid arteries
  • A split between the layers of your carotid artery wall. The split can weaken the wall or reduce blood flow to your brain.

A carotid ultrasound also might be done to see whether carotid artery surgery, also called carotid endarterectomy, has restored normal blood flow through a carotid artery.

If you had a procedure called carotid stenting, your doctor might use carotid ultrasound afterward to check the position of the stent in your carotid artery. (The stent, a small mesh tube, supports the inner artery wall.)

A carotid ultrasound sometimes is used as a preventive screening test in people at increased risk of stroke, such as those who have high blood pressure and diabetes​.

What Should I Expect Before a Carotid Ultrasound?

A carotid ultrasound is a painless test, and typically there is little to do in advance. Your doctor will tell you how to prepare for your carotid ultrasound.

What Should I Expect During a Carotid Ultrasound?

A carotid ultrasound usually is done in a doctor's office or hospital. The test is painless and often doesn't take more than 30 minutes.

The ultrasound machine includes a computer, a screen, and a transducer. The transducer is a hand-held device that sends and receives ultrasound waves.

You will lie on your back on an exam table for the test. Your technician or doctor will put gel on your neck where your carotid arteries are located. The gel helps the ultrasound waves reach the arteries.

Your technician or doctor will put the transducer against different spots on your neck and move it back and forth. The transducer gives off ultrasound waves and detects their echoes as they bounce off the artery walls and blood cells. Ultrasound waves can't be heard by the human ear.

The computer uses the echoes to create and record pictures of the insides of the carotid arteries. These pictures usually appear in black and white. The screen displays these live images for your doctor to review.

Your carotid ultrasound test might include a Doppler ultrasound. A Doppler ultrasound is a special test that shows the movement of blood through your arteries. Blood flow through the arteries usually appears in color on the ultrasound pictures.

What Should I Expect After a Carotid Ultrasound?

You usually can return to your normal activities as soon as the carotid ultrasound is over. Your doctor will likely be able to tell you the results of the carotid ultrasound when it occurs or soon afterward.

What Does a Carotid Ultrasound Show?

A carotid ultrasound can show whether plaque buildup has narrowed one or both of your carotid arteries. If so, you might be at risk of having a stroke. The risk depends on the extent of the blockage and how much it has reduced blood flow to your brain.

To lower your risk of stroke, your doctor may recommend medical or surgical treatments to reduce or remove plaque from your carotid arteries.

What Are the Risks of a Carotid Ultrasound?

A carotid ultrasound has no risks because the test uses harmless sound waves. They are the same type of sound waves that doctors use to record pictures of fetuses in pregnant women.

Source: National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services.

Other Resources

Experiencing a stroke or other interruptions in your carotid arteries can certainly be life-changing. But through the help of a carotid ultrasound, those events don't have to keep you from living your best life. Better understand your risk for heart disease:

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