Carotid Bruit - Auscultation Course

Carotid Bruit Course Overview

This course extends auscultation skills with carotid artery disease cases.

A bruit (pronounced 'broo-ee') is a vascular, whooshing sound, caused by turbulent blood flow in an artery which supplies blood to the brain. Increased stenosis of a carotid artery results in increased duration, intensity, and pitch of the bruit.

Carotid bruit sounds and a basal heart murmur are easily confused. Because the sounds radiate throughout the body, a heart murmur will be heard, with reduced intensity, at the auscultation points above the clavicle and a carotid bruit will be heard (again with reduced intensity) at the auscultation points below the clavicle. If the intensity of sound is greater above the clavicle, it is most likely a carotid bruit. If it is louder below the clavicle, it is most likely a heart murmur.

Use either the bell or the diaphragm when listening for the carotid bruit, at a point just lateral to the Adam's apple. Listen for the murmur of aortic stenosis at the second right intercostal space (2RICS).

An early systolic bruit is associated with a 50% decrease in carotid artery luminal diameter. A pansystolic bruit is associated with a 60% reduction in luminal diameter. A pansystolic bruit that extends into early diastole is associated with a decrease in luminal diameter of 70% to 80%.

For more information, visit Alan Lucerne and James Espinosa's article about carotid bruit found in the National Library of Medicine.