The Carotid Bruit

Carotid bruit: A review

“…4 Specifically, a carotid bruit is a low-pitched, adventitious vascular sound heard over the bifurcation of the common carotid artery into the internal and external carotid arteries. 5,6 Most commonly heard during systole, a carotid bruit is the result of blood flow turbulence immediately distal to an atherosclerotic area of arterial narrowing. 5 Portions of the atheroma can embolize and originate extracranially from the proximal internal carotid artery, causing either a TIA or stroke.…”

“…5,6 Most commonly heard during systole, a carotid bruit is the result of blood flow turbulence immediately distal to an atherosclerotic area of arterial narrowing. 5 Portions of the atheroma can embolize and originate extracranially from the proximal internal carotid artery, causing either a TIA or stroke. 7 Early results from the Framingham study reported an age-adjusted, 2.6 times greater incidence of stroke in patients with a bruit compared with those without a bruit.…”

“…The literature varies regarding use of the diaphragm or bell of the stethoscope during auscultation, but many sources recommend using the bell. 5,6,9 To avoid missing any bruits, consider using both. Several references suggest turning the patient's head slightly away from the side being examined.…”

“…Several references suggest turning the patient's head slightly away from the side being examined. 5,9 The area to be auscultated is located from the upper border of the thyroid cartilage to below the angle of the jaw. 5,6 This targeted area is bound superiorly by the angle of the jaw, inferiorly by the upper border of the thyroid cartilage, and posteriorly by the sternocleidomastoid muscle.…”

“…5,9 The area to be auscultated is located from the upper border of the thyroid cartilage to below the angle of the jaw. 5,6 This targeted area is bound superiorly by the angle of the jaw, inferiorly by the upper border of the thyroid cartilage, and posteriorly by the sternocleidomastoid muscle. 5,6 To auscultate the right carotid artery, position the bell of the stethoscope at the right upper border of the thyroid cartilage and have the patient hold his or her breath for approximately 15 seconds.…”