Carotid Bruits: The Sounds of Silence

Having suffered many assaults on my eardrums from patient vocalizations during auscultation for carotid bruits, I now ask patients to take a deep breath and hold it as I listen to the vessels in their neck. This not only protects my eardrums but also eliminates the sound of tracheal airflow, which can mask soft bruits. In addition, I find that palpating the radial pulse while I listen for carotid bruits seems to heighten my sensitivity to otherwise barely audible sounds.

---- Mark Kryger, MD