A carotid bruit (pronounced “broo-ee”) is an unusual sound heard over the carotid arteries in the neck during a routine physical examination. These major blood vessels supply oxygen-rich blood to the brain. Discovering a bruit can prompt further medical evaluation.
What is a Bruit?
A bruit refers to an abnormal sound generated by turbulent blood flow within an artery. It is often described as a “whooshing” or “swishing” noise. Healthcare providers detect bruits using a stethoscope. This sound is not typically felt by the patient, a clinical sign identified by a medical professional. In the neck, bruits are associated with the carotid arteries, which deliver blood to the brain.
Why a Neck Bruit Occurs
A neck bruit primarily occurs due to turbulent blood flow through a narrowed or irregular blood vessel. The most frequent cause of this narrowing in the carotid arteries is atherosclerosis, a condition where plaque builds up inside the artery walls. This plaque accumulation restricts the artery’s opening.
Plaque buildup can also lead to the formation of blood clots, which may further obstruct blood flow or travel to other parts of the body. While atherosclerosis is the most common reason for a neck bruit, other less frequent conditions can also cause this turbulent flow. Fibromuscular dysplasia (FMD), a disorder involving abnormal cell growth in artery walls, can also result in a bruit. Additionally, conditions that increase the speed of blood flow, such as hyperthyroidism, can sometimes cause bruits.
How a Neck Bruit is Diagnosed
The diagnostic process for a neck bruit begins with a healthcare provider listening to the neck arteries with a stethoscope. If a bruit is heard, further investigation is often necessary to determine its cause and potential severity. The primary diagnostic tool used for this purpose is usually a carotid ultrasound.
This non-invasive test uses sound waves to visualize blood flow and identify any narrowing or blockages within the carotid arteries. A carotid ultrasound can provide detailed information about the structure of the blood vessels, as well as assess blood flow and pressure.
For more complex cases or when additional detail is required, other imaging tests may be considered. These can include CT angiography (CTA), which uses X-rays and a contrast dye to create detailed images of blood vessels, or magnetic resonance angiography (MRA), which uses magnetic fields and radio waves to visualize blood flow.
What a Neck Bruit Means for Your Health
The presence of a neck bruit signals turbulent blood flow, but its significance can vary. Sometimes, particularly in younger individuals, a neck bruit may be an “innocent” finding, meaning it does not indicate a serious underlying condition.
However, for adults, especially those with risk factors for cardiovascular disease, a neck bruit can be a sign of underlying carotid artery disease. This condition involves plaque buildup in the carotid arteries, which increases the risk of a stroke or transient ischemic attack (TIA).
A carotid bruit can suggest the presence of moderate to severe atherosclerosis in the extracranial carotid artery. While a bruit indicates a potential issue, it does not reveal the extent of plaque buildup, and some individuals with significant narrowing may not even have a bruit.
Therefore, the detection of a neck bruit warrants further evaluation by a healthcare professional to assess the risk of stroke and guide appropriate management. Early detection and proper management of carotid artery disease can significantly lower stroke risk.