DEAR DR. GOTT:
My husband has an unusual condition which none of his physicians have been able to diagnose or treat successfully.

He is 57, has had two heart attacks but is now healthy and has a low blood pressure. He is on Zetia, Benecar, Lipitor, aspirin and Effexor.

His problem is that when he lies on his left side, he hears a pulsating blood flow noise in his right ear. It has the same timing as his heart beat. If he turns his head to the right or lies on his right side the noise stops. Occasionally it happens while he is standing or sitting upright. It is not debilitating but is very irritating to him. If he presses on the carotid artery, the sound stops but resumes once he releases the pressure. He cannot remember if this started before or after his heart attacks.

His hearing has been checked and is normal.

We would both appreciate any suggestions you may have. He claims he will even sleep with a bar of soap under his neck if it will help.

DEAR READER:
A noise in the neck that stops when pressure is applied to the carotid artery suggests that there may be blockage in that artery.

This possibility can be very dangerous. If left untreated, the blockage will get larger and may severely reduce or stop blood flow through the artery. A piece may also break off and be carried to the brain where it could lead to stroke.

Therefore, I recommend that your husband ask his physician to order a carotid ultrasound. It is safe and easy. This will diagnose a blockage if one is present.

If, as I suspect, your husband has a blockage, treatment will depend on the severity. He will most likely need to start anticoagulant therapy such as warfarin (Coumadin). He may also benefit from a procedure called angioplasty that uses a balloon-like device to break up the blockage and restore blood flow.

Your husband’s cardiologist is the best source for more information about causes and possible treatment options. I suggest you start with him or her and bring along a copy of my response to your letter. Let me know how this turns out.

To give you related information, I am sending you copies of my Health Reports “Coronary Artery Disease” and “Stroke”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 FOR EACH report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).