August 19, 2019 – Neck Sounds
Anchor lead: A sound heard through a stethoscope on the neck may indicate a blood vessel problem, Elizabeth Tracey reports
If you’ve had a recent physical exam your clinician may have used a stethoscope to listen to your neck. That’s because a sound called a ‘bruit’ may indicate blockage there, putting you at very high risk for a stroke. Bruce Perler, a vascular surgeon at Johns Hopkins, says further evaluation is needed if a bruit is heard.
Perler: Carotid bruit is really the only physical sign that there may be carotid disease but it’s a pretty insensitive and nonspecific physical finding. Many patients have bruits for a number of reasons. It may be a transmitted heart murmur or it may be from a vessel other than the internal carotid artery and conversely there are patients with severe carotid blockages who don’t have bruits. So while we look for bruits and its certainly an indication for getting a carotid ultrasound, if you just rely on a bruit you may miss patients who have significant carotid disease. :29
Perler says it is critical to have an ultrasound at an accredited center that regularly performs such studies as he sees many results that must be repeated. At Johns Hopkins, I’m Elizabeth Tracey.