Carotid bruit

Carotid bruit is a sound detected during auscultation that originates from the carotid artery. This systolic sound may provide important clues to the condition of the carotid artery and its potential pathologies.

Definition

A carotid bruit is a systolic sound heard over the carotid artery area during auscultation. It arises when turbulent blood flow occurs in the artery due to some underlying irregularities, which might be either physiological or pathological.

Associated conditions

The sound of a carotid bruit is often associated with carotid artery stenosis.<ref name="pmid13768297">MATTHEWS WB,

 OBSERVATIONS ON THE CAROTID BRUIT, 
 J. Neurol. Neurosurg. Psychiatr., 
 
 Vol. 24(Issue: 2),
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 Full text,</ref> However, some sources argue against this association.<ref name="pmid18368873">Mayock R, 
 Does a carotid bruit predict cerebrovascular complications following noncardiac surgery in asymptomatic patients?, 
 Cleve Clin J Med, 
 
 Vol. 74 Suppl 1,
 pp. S18–9,
 
 PMID: 18368873,
 
 
 Full text,</ref> Notably, most carotid bruits, especially in younger or asymptomatic individuals, are not indicative of any pathological condition and are termed "innocent carotid bruits".<ref>Bates' Guide to Physical Examination and History Taking, 9th Ed, Chapter 20</ref>

A carotid bruit might not be audible if the stenosis affects less than 40% of the artery's diameter. Conversely, in cases where the stenosis exceeds 90%, the bruit may also be absent due to decreased flow through the artery. ^{(June 2009)}

For many patients, carotid bruits are detected incidentally when they exhibit no other symptoms. It is crucial to note that the mere presence of a carotid bruit does not confirm stenosis. Physical examinations alone cannot determine the stenosis's extent. Hence, any detected bruit must be further investigated through ultrasound or other imaging modalities.<ref name="DeGowin">DeGowin's Diagnostic Examination, 9th Edition, Chapter 8; Richard F. LeBlond, Donald D. Brown, Richard L. DeGowin</ref>

Pronunciation and terminology

The term "bruit" is traditionally pronounced broot, which rhymes with boot. Nevertheless, in North American medical settings, the pronunciation bru´e or bru-e´ is also common.<ref>Stedman's Medical Dictionary - 28th Ed.</ref> While bruit and murmur can be used interchangeably, the term bruit is typically reserved for arterial sounds in North America.<ref name="DeGowin" />

See also

• Auscultation
• Vascular murmur
• Carotid artery

References

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