You’re in for your regular check-up, feeling pretty good. I’m going through the usual listen to your heart, your lungs. Then, I gently place my stethoscope on the side of your neck, just under your jawline. Sometimes, in that quiet moment, I hear a little something extra – a soft ‘whoosh-whoosh’ sound with each heartbeat. That subtle sound, my friend, might be what we call a carotid bruit.
It’s not something you’d hear yourself, only something we can pick up with a stethoscope. And it often makes me pause and think, “Okay, let’s explore this a bit.”
So, What Exactly is a Carotid Bruit?
Let’s break it down. A carotid bruit (it’s pronounced “broo-ee,” kind of fancy, I know!) is simply the sound of blood flowing in a not-so-smooth way through one of your carotid arteries. You have two of these major arteries, one on each side of your neck, and they’re super important because they carry oxygen-rich blood up to your brain.
Think of a calm river. That’s how blood usually likes to flow – smoothly. But if there’s a rock, or the river narrows, the water gets a bit choppy, a bit turbulent. A carotid bruit tells us the blood flow in that artery might be a little turbulent, not quite as smooth as we’d like.
What Does This “Whoosh” Sound Like to Me?
It’s a distinct rushing or whooshing sound. To check for it, I’ll listen to a few spots on your neck. I might even ask you to take a deep breath and hold it for a few seconds. This helps me hear things more clearly without the sound of your breathing.
If I do hear a carotid bruit, it doesn’t automatically mean panic stations. Not at all. But it does mean we should chat about what it could mean and if we need to look any further.
What Causes a Bruit in the Carotid Artery?
The most common reason we hear a carotid bruit is something called atherosclerosis. That’s the medical term for when fatty deposits, or plaque, build up inside your arteries. Imagine gunk slowly building up in a pipe – it makes the opening narrower.
When this plaque builds up in your carotid arteries, it’s called carotid artery stenosis. Stenosis just means narrowing. This narrowing can:
- Make the blood flow turbulent (causing the bruit).
- Worryingly, increase the risk of a blood clot forming.
- If a clot blocks the artery or a piece breaks off and travels to the brain, it can lead to a transient ischemic attack (TIA), sometimes called a “mini-stroke,” or a full-blown ischemic stroke.
That’s why a carotid bruit can be an important heads-up. It’s a clue that there might be some plaque buildup we need to know about.
Now, plaque is the usual suspect, but sometimes other things can cause a bruit. For instance, conditions like fibromuscular dysplasia (FMD), which affects the structure of artery walls, can also create that sound. We’d look at your whole health picture to figure out the likely cause.
How Serious Is a Carotid Bruit, Really?
This is the big question, isn’t it? A carotid bruit can be a sign of something serious, like significant carotid artery stenosis that needs attention to lower your stroke risk. But, and this is a big “but,” it’s not always the case.
Sometimes, I hear a bruit in folks who have perfectly healthy carotid arteries, or maybe just very mild changes. And, weirdly enough, some people with quite severe narrowing don’t have a bruit at all! So, it’s a clue, an indicator, but not a diagnosis on its own. It’s one piece of your health puzzle.
Okay, I Have a Carotid Bruit. What’s Next?
If I hear a carotid bruit, especially if you have other risk factors for artery disease, we’ll likely want to get a clearer picture of what’s happening inside those carotid arteries. The go-to test for this is a carotid duplex ultrasound.
It’s a completely painless and noninvasive test, much like the ultrasounds used during pregnancy. A technician will use a probe on your neck, and sound waves will create images of your arteries and show us how the blood is flowing. This test can tell us if there’s narrowing, and if so, how much.
We’re more likely to suggest this ultrasound if you have a carotid bruit and also:
- Have known coronary artery disease (heart artery blockages).
- Live with diabetes.
- Have a family history of stroke.
- Struggle with high blood pressure.
- Have high cholesterol.
- Are older (generally over 65, or over 55 with other risk factors).
- Have peripheral artery disease (blockages in leg arteries).
- Use tobacco products. The more of these you tick off, the higher the concern.
Also, if you’re heading for certain types of heart surgery, like coronary artery bypass grafting (CABG), your surgeon will likely want your carotids checked beforehand. Significant carotid stenosis can increase stroke risk during or after such surgeries.
What If I Need Treatment?
If the ultrasound shows significant narrowing, the goal is to improve blood flow and reduce your risk of a TIA or stroke. Don’t worry, we have good ways to manage this.
Often, we start with:
- Medications:
- Lifestyle Changes: These are powerful!
For more severe blockages, or if you’ve already had a TIA or stroke related to the narrowing, we might discuss procedures:
- Carotid endarterectomy: This is a surgical procedure where a surgeon carefully opens the carotid artery and removes the plaque.
- Carotid angioplasty and stenting: A less invasive option where a tiny balloon is used to widen the artery, and then a small mesh tube (a stent) is often placed to keep it open.
Remember, not everyone with a carotid bruit has a blockage or needs these treatments. It’s all very individual.
Take-Home Message: What to Remember About Carotid Bruit
So, let’s quickly recap the main points about that carotid bruit:
- It’s a ‘whooshing’ sound your doctor might hear in your neck with a stethoscope.
- It means blood flow in your carotid artery (taking blood to your brain) might be turbulent.
- Often, it’s a clue for atherosclerosis (plaque buildup) which can lead to carotid artery stenosis (narrowing).
- It can be a warning sign for increased risk of TIA or stroke, but not always.
- A carotid duplex ultrasound is the usual next step to check your arteries.
- Treatment, if needed, ranges from medications and lifestyle changes to procedures like endarterectomy or stenting.
Hearing you have a carotid bruit can be a bit unsettling, I understand. But it’s often the first step towards getting a better understanding of your artery health and taking proactive steps. We’ll discuss all the options and what makes the most sense for you.
You’re not alone in this. We’re here to figure it out together.