When a doctor listens to your neck during a physical examination, you might hear the medical term “carotid bruit.” This refers to a specific sound a healthcare provider detects over the carotid arteries in your neck. Its presence can prompt further medical evaluation to understand what might be happening within these important blood vessels.
Understanding a Carotid Bruit
A carotid bruit is a distinct whooshing or swishing sound heard over the carotid arteries. This sound indicates that blood flow within the artery is turbulent or disorganized. Normally, blood moves through arteries without making an audible sound.
The carotid arteries are a pair of major blood vessels, one on each side of the neck. They deliver oxygen-rich blood from the heart to the brain, face, and neck. A carotid bruit suggests an alteration in the normal, laminar flow of blood.
Common Causes of a Carotid Bruit
The most frequent reason for a carotid bruit is carotid artery stenosis, a narrowing of the artery. This narrowing results from atherosclerosis, a condition where plaque, a sticky substance made of fat, cholesterol, and other materials, builds up on the artery walls. As plaque accumulates, it reduces the artery’s internal diameter, causing turbulent blood flow and the whooshing sound.
While atherosclerosis is the primary concern, other less common factors can also lead to a carotid bruit. A hyperdynamic circulatory state, such as severe anemia or hyperthyroidism, can cause turbulent flow. Additionally, a tortuous, or kinked, carotid artery, an anatomical variation, can sometimes produce a similar sound. The main focus of investigation when a bruit is detected is to rule out or assess the severity of carotid artery stenosis.
What Happens After a Carotid Bruit is Detected
If a healthcare provider hears a carotid bruit, further investigation is recommended to determine its underlying cause and significance. The most common follow-up test is a carotid ultrasound, a painless, non-invasive procedure that uses sound waves to create images of the carotid arteries. This ultrasound helps determine any narrowing or blockage due to plaque buildup and assesses the degree of stenosis.
Based on the ultrasound findings and a patient’s overall health and risk factors, various management strategies may be considered. If the narrowing is minor or deemed benign, no specific treatment beyond lifestyle adjustments may be necessary. For more significant stenosis, lifestyle changes such as quitting smoking, adopting a healthy diet, and regular exercise are advised, alongside medications to manage blood pressure or cholesterol levels. In cases of severe carotid artery narrowing, particularly if symptoms like transient ischemic attacks (TIAs) have occurred, surgical interventions like carotid endarterectomy (plaque removal) or carotid angioplasty with stenting (widening the artery with a small mesh tube) may be recommended to improve blood flow and reduce stroke risk.