Facts on File Encyclopedia of Health and Medicine

occlude the inner channel of the carotid artery.
Carotid bruit is a diagnostic sign that indicates the
presence of CAROTID STENOSIS (narrowing of the
carotid artery) and increased risk for STROKE.
See also ANGIOGRAM; ENDARTERECTOMY; HEART
SOUNDS; STENT.

carotid stenosis Narrowing of the carotid ARTERY
in the neck due toATHEROSCLEROSIS. Often carotid
stenosis shows no symptoms until it results in a
STROKE. The doctor may detect carotid stenosis
during routine physical examination when listen-
ing to the carotid arteries with a STETHOSCOPE,
which reveals the characteristic murmur sound,
CAROTID BRUIT, that indicates the stenosis. ANTICO-
AGULATION THERAPY, most commonly ASPIRIN
THERAPY, helps reduce the risk of clot formation at
the site of the stenosis though does not prevent or
reduce atherosclerotic accumulations. ENDARTEREC-
TOMY, surgery to remove the occluding atheromas
(collections of ATHEROSCLEROTIC PLAQUE) and widen
the arterial passage, becomes a viable treatment
option when the stenosis reaches 60 or 70 per-
cent. ANGIOGRAM, in which the cardiologist uses
dye and X-rays to examine the arteries, helps
define the degree of occlusion. Stroke occurs
when clot or atheroma fragments break free from
the site of the stenosis and travel through the
carotid artery to the BRAIN.
See also CARDIOVASCULAR DISEASE PREVENTION; SUR-
GERY BENEFIT AND RISK ASSESSMENT.

chest pain Discomfort that arises from the upper
portion of the body. CHEST PAINcan have various
causes, many of which are not cardiovascular. Dis-
comfort originating from the HEARTis characteristi-
cally oppressive in nature, though often not the
crushing pressure that is the common perception.

As many as 25 percent of people do not experi-

ence appreciable pain with HEART ATTACK. Gastroin-

testinal pain often sends people to the emergency

room worried about heart attack, yet nearly a

third of people who are having heart attacks delay

seeking medical care because they do not believe

the symptoms they are experiencing, especially

chest pain, are severe enough to be heart attack.

Chest pain is unreliable as an indicator of the

nature or severity of a health situation.

HEALTH CONDITIONS THAT CAN CAUSE CHEST PAIN

BARRETT’S ESOPHAGUS COSTOCHONDRITIS

dissecting aorticANEURYSM ENDOCARDITIS

GALLBLADDER DISEASE GASTROESOPHAGEAL REFLUX

HEPATIC ABSCESS DISORDER(GERD)

LUNG ABSCESS HIATAL HERNIA

PANCREATITIS MYOCARDITIS

PERICARDITIS PEPTIC ULCER DISEASE

PLEURISY PNEUMONIA

PULMONARY EMBOLISMwith ribFRACTURES

infarction STOMACH CANCER

See alsoCARDIOPULMONARY RESUSCITATION (CPR);

CHONDRITIS; COCAINE.

cholesterol blood levels The amounts and forms

of cholesterol that are present in the bloodstream,

usually measured after 8 to 12 hours of fasting (no

food) to accommodate short-term rises that could

result from eating. Cholesterol is a sterol, a chemi-

cal essential for numerous metabolic functions

and necessary for health. Because cholesterol can-

not dissolve in the BLOOD, it binds with protein

carriers called lipoproteins that suspend it in the

blood. Cholesterol becomes a health problem

when the amount of cholesterol in the blood cir-

cholesterol blood levels 35

CHOLESTEROL BLOOD LEVELS AND CARDIOVASCULAR HEALTH

Cholesterol Optimal Moderate Risk High Risk
HDL-C >–60 mg/dL < 40 mg/dL not applicable
LDL-C <– 100 mg/dL 130–159 mg/dL >160 mg/dL
total cholesterol < 200 mg/dL 200–239 mg/dL >–240 mg/dL
*For people with no other cardiovascular risk factors, LDL-C levels of 100–129 mg/dL is optimal. For people with other cardiovas-
cular risk factors, LDL-C levels of 100–129 mg/dL is nearly optimal/slight risk.