Understanding Carotid Artery Stenosis
A 42-year-old woman has been diagnosed with the following conditions: - Autoimmune Arthritis - Hypermobile Ehlers-Danlos Syndrome - Mild Sleep Apnea associated with hypoxemia - Chronic cervical radiculopathy originating from the C7 vertebra - Mild stenosis at C5, C6, and C7 - Osteopenia in the left hip - Irritable Bowel Syndrome (IBS) - Attention Deficit Hyperactivity Disorder (ADHD) Current Medications include: - Hydroxychloroquine - Adderall For approximately six months, she has experienced episodes characterized by ear congestion and feelings of lightheadedness during walking, exercising, or other physical activities, often requiring her to pause or lean on something for support. Initially occurring twice a month, these episodes became weekly and have now escalated to a daily occurrence. While her insurance declined coverage for brain imaging, they did authorize a carotid Doppler ultrasound. The results indicate that there is stenosis ranging from 50% to 69% in the distal right internal carotid artery, and the proximal left common carotid artery, as well as the left internal carotid artery, are also affected in the same range. Given this diagnosis, she wonders if it could explain her symptoms and whether it would be worth appealing the decision regarding imaging. Despite having low blood pressure, normal blood sugar levels, and healthy cholesterol numbers, the stenosis results were unexpected. Additionally, she experiences other neurological symptoms, including numbness, which she suspects may stem from a previously undiagnosed pinched nerve. She is seeking advice on pertinent questions to discuss with her primary care physician during their next appointment. Any suggestions or insights would be highly valued. 😊
Answers (1)
8/22/2025, 11:01:13 PM
OpenHealth AI
It's understandable that you're feeling concerned about your recent diagnosis and symptoms, especially given the complexity of your condition. Carotid artery stenosis, particularly in the range of 50% to 69%, can lead to reduced blood flow to the brain, which might explain your episodes of lightheadedness and ear congestion. Let’s break down the key points and provide some actionable steps for your next appointment with your primary care physician.
Key Points:
- Symptoms Connection: Your symptoms could indeed be related to the carotid artery stenosis. Reduced blood flow may lead to dizziness, especially during physical activities.
- Potential Neurological Impact: The presence of other neurological symptoms, such as numbness, may warrant further investigation to rule out other contributory factors.
- Need for Brain Imaging: Given the severity of stenosis and your symptoms, there is a strong case for appealing the insurance decision regarding brain imaging to fully assess your condition.
Next Steps:
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Questions to Discuss:
- Could the carotid artery stenosis be causing my lightheadedness and ear congestion?
- What neurological evaluations do you recommend, especially for my symptoms of numbness?
- Given my medication and health conditions, how can we safely manage the stenosis? Should lifestyle changes be implemented?
- What are my options for appealing the insurance decision on imaging? Is there urgency in obtaining brain imaging?
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Prepare for the Appointment:
- Symptom Diary: Track your episodes of lightheadedness, ear congestion, and any neurological symptoms like numbness. Note the timing, triggers, and duration of these symptoms to share with your doctor.
- Medication Review: Write down all current medications and any side effects you are experiencing, as this information may help your doctor assess treatment options.
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Lifestyle Considerations:
- Maintain hydration and a balanced diet to optimize overall health. This can be particularly important in managing symptoms related to chronic conditions like sleep apnea and IBS.
- Discuss with a physical therapist about exercises that can improve your stability and reduce the risk of falls during episodes of lightheadedness.
Follow-Up Actions:
- After your appointment, follow up on the appeals process for brain imaging if necessary.
- Consider a referral to a neurologist for further evaluation of your neurological symptoms.
Your proactive approach to understanding and managing your health is essential. Don't hesitate to share all your concerns during the visit. Wishing you the best in your discussions with your doctor! 😊
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