Bruits

A bruit is an abnormal, often whooshing sound heard over an artery with a stethoscope, produced by turbulent blood flow. It typically indicates some disturbance in normal circulation within a vessel, such as partial narrowing or irregularity.

Turbulence arises when blood accelerates through a narrowed segment, through an arteriovenous fistula, or in other high-flow situations. Bruits are usually low to mid-frequency sounds and are best detected with the bell of a stethoscope; they may vary with body position, breathing, or changes in blood pressure.

Common sites include the carotid arteries in the neck (carotid bruit), the abdominal aorta or iliac arteries (abdominal bruit), and the renal or femoral arteries. Bruits can also be heard over other peripheral arteries but are less common there. Not all bruits reflect dangerous disease; some occur with benign conditions or high-flow states such as anemia or pregnancy.

Evaluation typically begins with careful auscultation. If a bruit is heard, duplex Doppler ultrasonography is often the first-line imaging test to assess the extent of any arterial narrowing. CT or MR angiography may be used for detailed anatomy, and catheter angiography remains a diagnostic option in selected cases.

Clinical significance varies by site and patient. A carotid bruit may signal carotid stenosis and stroke risk, but its presence alone does not guarantee clinically significant disease. Management focuses on risk factor modification and, when indicated, referral to vascular specialists for further assessment or intervention.