Q and A: How Long Does It Take For Someone To Die From Carotid Artery Compression?

09 Jul

Q: How long does it take for someone to die if their carotid artery is compressed?

A: The two carotid arteries lie in the front of the neck on either side of the trachea (windpipe) and carry blood from the heart to the brain. They supply 90% or so of the brain’s blood, with the rest coming from the two small vertebral arteries that travel along the spine and over the back-most portion of the brain. The carotids are interconnected in the brain so that in a normal individual compressing a single carotid artery will have little effect. Compressing both can cause a loss of consciousness in 15 to 20 seconds and death in 2 to 4 minutes.

One general rule in medicine is that if the heart stops, the victim will lose consciousness in about 4 seconds if standing, 8 if sitting, and 12 if lying down. This simply reflects the effects of gravity on blood flow. These numbers would also mostly hold true if both carotids were suddenly pressed shut—not easy to do—see below. But, to the brain, the complete interruption of blood flow through carotids would look the same as it would if the heart had stopped. Either way, the brain would receive no blood supply, and the brain needs a continuous supply of blood to function and survive.

Another medical truism is that dizziness, loss of consciousness, and sudden death are simply gradations along the same scale. That is, what makes you dizzy can make you lose consciousness, and what makes you lose consciousness can cause death. One of the things that can do this is compression of the carotid arteries. Brief compression, can cause dizziness, longer compression can cause loss of consciousness, and even a longer period of compression can cause death.

A major variable in play here is how severely the arteries are compressed. If only partially collapsed, the victim might have no problems. Severe and almost complete compression can cause loss of consciousness and death in short order. And anywhere in between. Significant and potentially deadly compression can result from strangulation–either manual or ligature–hanging, or an aggressively applied choke hold.

So, depending upon the nature, force, and duration of the compression, your victim could have no symptoms, become dizzy, lose consciousness, or die. Or could progressively move from one of these to the next. The time required for death could be a couple of minutes or many minutes if the compression is less severe or intermittent. As the victim struggled, he could intermittently release the strangle or choke hold and this would prolong the ordeal.

All these variable means that you can have it almost anyway you want. The killer could overpower the victim, render him unconscious in 20 seconds, and kill him in 2 minutes. Or the struggle could go on for many, many minutes. It’s up to you.


Posted by on July 9, 2011 in Medical Issues, Q&A, Trauma


36 responses to “Q and A: How Long Does It Take For Someone To Die From Carotid Artery Compression?

  1. Fritz Strobl MD

    July 9, 2011 at 9:11 pm

    Nice subject review. I used Carotid Sinus Massage in my novel Presidential Migraines(c) to defeat a foe. When we used to do “direct stick” carotid angiography years ago, we used to compress the opposite carotid to look for contralateral collateralization. Always a concerning time not just for the compression causing decreased flow but knocking off a plaque on either side either with the needle or the compression itself.


  2. J.D.

    July 11, 2011 at 6:04 am

    If the carotids were stopped up, would that be a factor? As I write this next part, it seems a given—a 70 year-old would require less compression and less time than a 20 something?


    • D.P. Lyle, MD

      July 11, 2011 at 7:02 am

      Yes that’s true. The old, young, weak, or sedated have either less muscular necks or a reduced ability to defend themselves and are more susceptible to strangulation and carotid compression.


    • Fritz Strobl MD

      July 14, 2011 at 11:45 am

      Generally yes, older patients are more susceptible. I agree with Dr. Lyle. A lot depends on collateralization – read about Circle of Willis. And then, what are you doing to their trachea?

      Liked by 1 person

  3. Eloise Hill

    July 11, 2011 at 10:12 am

    Didn’t know about the 4, 8, 12 second rule—very interesting. I read an article, many years ago, about a jounalist who did an interview with a Vietnam vet who suffered from severe PTSD. At some point in the interview, he became agitated and attempted to strangle the journalist. She barely managed to avoid lapsing into unconciousness and escape but the article stated she suffered chronic “health effects”,with no details. Any idea what those would most likely be?


    • D.P. Lyle, MD

      July 11, 2011 at 10:15 am

      The 4, 8, 12 rule is very general and in the end whatever happens, happens. She could have suffered some brain damage for lack of oxygen for a while, or an neck or larynx injury from the trauma, or it could simply be lawyer speak for give me some money. But I wax cynical.


  4. Maria von Ruhtenberg

    May 1, 2013 at 5:30 pm

    If a person is drunk would it take less time to die from strangulation?


    • D.P. Lyle, MD

      May 2, 2013 at 7:54 am

      Not really. Strangulation results in the restricting of blood flow thru the carotid arteries to the brain leading to death. Alcohol in the blood would have no real effect on this situation.


    • Marilyn Thomas

      January 10, 2016 at 5:30 am

      No you will not live longer. The fact is you will go with all the blows twisting and turning attempts to end your life. I was told by a doctor I was the drunk driver that didn’t die.


  5. Christopher Valen

    May 10, 2013 at 1:10 pm

    I have a perpetrator in the new John Santana novel I’m working on who is skilled in judo. Would a properly applied choke hold leave external evidence and/or internal evidence that could be found during an autopsy?


    • D.P. Lyle, MD

      May 10, 2013 at 1:40 pm

      Both in most cases. External bruising and perhaps some internal bleeding into what are called the strap muscles of the neck.


  6. Danielle Jacobs

    August 7, 2013 at 12:01 pm

    Question: If your carotid artery was sliced by a perpetrator how long would you have consciousness for inorder for you to get help? Also how long of life after such tragedy until you pass away?

    Liked by 1 person

    • D.P. Lyle, MD

      August 7, 2013 at 12:58 pm

      Danielle–I don’t answer such questions here but rather only thru my website. I require certain info first. This can be found on the site. Please supply the needed info and resubmit your questions thru the website.


  7. Danielle Jacobs

    August 7, 2013 at 1:09 pm

    Where do I provide you with the info on your website?


  8. James

    October 9, 2013 at 4:45 pm

    How much force needs to be applied to a carotid in order for it be compressed to the point of unconsciousness?


    • D.P. Lyle, MD

      October 9, 2013 at 4:49 pm

      I don’t answer such questions on my blog but rather only thru my website as I require certain information beforehand. Visit my site at and you’ll find the info needed to submit your questions.


  9. Nicole

    November 22, 2013 at 5:05 am

    Okay, my question has more to do about something hitting you in the neck, rather that someone trying to kill you. Two nights ago, I was bringing a large ‘pan’ back to the dish room. I use pan lightly, since it’s this large piece of metal that catches the grease from the fries in a separate container above. This metal piece is quite heavy and it has a particularly pointy side, which was facing towards me. I had to lift it up, about neck level, in order to maneuver around the packed grill area. Right before I passed the corner, I somehow managed to bang into the wall. The metal went right into my neck enough to make me gasp for air. I had to regain my composure, since I’m more of a suck it up and deal kind of girl. I’ve done this a million times on nights where I am dead tired, yet I’ve never managed to do that before. Now, this was at work, so about a minute after it happened, I was I was talking to a customer and I almost toppled out the drive-thru window. Maybe a few seconds later, I was dizzy again. This dizzy for a second thing lasted for a few hours, then I came home and went to bed. I have a nice little bruise on my neck, but my question is… How close was I to a serious injury or death? And should I still be concerned?


    • D.P. Lyle, MD

      November 22, 2013 at 7:06 am

      Nicole—I never comment on someone’s health here as it would be inappropriate and bad medicine. Every situation is different and there is no way to answer your question accurately for your particular situation. If you are concerned, see your own physician and discuss this with him/her.


      • laraib

        October 28, 2014 at 1:52 am

        what is the mechanism involved in being unconcious after compression of carotid artery? is it something related to baroreceptors???


      • D.P. Lyle, MD

        October 28, 2014 at 8:04 am

        Baroreceptor compression is part of it but mostly it is a collapse of the artery from the external pressure and obstruction of blood flow to the brain—which requires constant blood flow to function and survive. So with significant compression of both arteries consciousness can be lost in 20-30 seconds and brain damage and ultimately death follows.


  10. Benson D Y

    February 18, 2014 at 1:16 pm

    I truly appreciate your deliberation on this very issue.


  11. BINOD KUMAR Sharma

    December 19, 2014 at 11:51 pm

    Dear Dr Lyle I am a Orthopedic Surgeon and have suffered from episodic right sisded cluster headaches since I was 18 years old ie since 1979.The bouts occur once a year and continue for 1 to 2 months with a frequency of 1 to 2 attacks per day lasting 1 to 2 hours.After consulting numerous Doctors in the last 35 years and various medications eg Inderal Diltizem Lithium for prophylaxis and Sumatriptan /rizatriptan for acute attacks (which provided no benefit ) during my medical student days I started to use carotid compression for releif of the excruciating pain during acute attacks.I have practised both unilateral and bilateral carotid compression since 1981 during my episodes .I usually practised complete compression which led to brief loss of conciousness followed by recovery and and temporary releif of the pain followed by return of the headache followed by repetition of the procedure till the bout was over.Currently I am in a bout of cluster head ache and during this episode I have found that even partial compression of the ipsilateral carotid provides releif.I have not noticed any deleterious effects inspite of almost 35 years of this exercise for releif of pain. I will appreciate your views. You may reply me on


    • D.P. Lyle, MD

      December 20, 2014 at 6:13 am

      For reasons I’m sure you understand I do not give medical advice through this blog and on people I do not know and have not examined but I will say that playing with carotid compression is like playing with a loaded gun. Strokes, cardiac arrest, and death are real possibilities. Talk to your neurologist about this.


  12. john best

    February 2, 2015 at 10:51 am

    Any info on best way to position the rope to compress carotid by short drop hanging? Thank you.


    • D.P. Lyle, MD

      February 2, 2015 at 11:01 am

      John—I don’t answer such questions here but rather only thru my website as I require certain information before responding. Please visit and submit your questions that way.


  13. Rhonda

    October 15, 2015 at 10:31 am

    My question is in regard to getting popped in front of my left ear a few days ago by my boyfriends elbow. I was flopping back on bed beside him as he decided to grab a pillow for me…BAAAAAD TIMING..
    His right elbow was coming up with force just as I was flopping down with force, and caught me just in font of my left ear at cheek bone. Immediately the pain was excruciating. For the rest of the day, I could barely keep my eyes open, even when I was standing and talking. I could barely open my mouth enough to eat a sandwich later in day and my face felt limp, or heavy…expressionless all day. Totally lethargic that day. The next day my energy was still very low.
    I started googling after injury and it seems to have compressed the left external carotic artery and from my research this seems to run paralell to my injury. I was wondering if a quick precise blow to the artery in that location could possibly do permanent or lingering damage that may need addressed? Thank you.


    • D.P. Lyle, MD

      October 15, 2015 at 10:50 am

      Rhonda—I never comment on real life medical situations as each is different. I suggest you talk with your own physician.


  14. Ashton

    March 21, 2016 at 11:14 am

    Great info but you can choke a person out faster than 15 seconds. My record is about 4


  15. terra

    April 9, 2016 at 5:58 am

    Hi I was in a life and death mater with my ex in Sept 2015 he tried to kill me he chocked me standing n laying down . Hit my head a lot etc.. I belive I died and came back when he was choking me on the ground .. I could not move or hear anything or feel anything . I could see all black then white and I heard in my head me saying I have a daughter that I’m not readying to die .. but I didn’t say it . So did I die for a few minutes just wondering I think I did. And I’m having problems still in my neck it like pops and moves and hurts time to time . Is that normal ??? It happened 8 months ago and it still don’t feel right.


    • D.P. Lyle, MD

      April 9, 2016 at 7:02 am

      I can’t really answer your questions for many reasons but I suggest that if you are still having symptoms you should see your physician.


  16. Robert nowak

    July 20, 2017 at 11:49 am

    Why do u use the word compression for a cut artery? Look, I’m a high school dropout, BUT lately im seeing word’s that make no sense to me, LIKE COMPRESSION. I KNOW WHAT THAT WORD MEENS, BUT IT’S TOTALLY OUT OF CONTEXT. The ONLY time u used it in CONTEXT, is when u said about putting compression on someone’s neck in a choke hold. YES, I’M BORED TO DEATH!!


    • D.P. Lyle, MD

      July 20, 2017 at 1:04 pm

      It’s not about a cut artery, it’s about compressing an intact artery through the skin. Like chest compressions during CPR, which are intermittent—60 per minute to simulate the heart beat and push the blood along. Here it is to constrict the artery and thus restrict the blood flow.



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