Carotid bruit is auscultated in which condition?

• A. Aortic valve stenosis and regurgitation
• B. Aortic valve stenosis
• C. Mitral stenosis
• D. Tricuspid regurgitation

Answer: (A)

A carotid bruit reflects turbulent blood flow in the carotid arteries, most often from narrowing due to atherosclerotic plaque. When the carotid arteries are stenotic, the velocity of flow increases and creates a swishing sound you can hear with a stethoscope over the neck. This finding directly points to carotid artery disease and raises concern for increased stroke risk, so it’s a clue to pursue carotid duplex ultrasound to assess the degree of stenosis and guide management.

The other conditions listed involve the heart valves and produce murmurs best heard at the heart sounds or along the left sternal border, not the carotid arteries. Valvular disorders like aortic valve disease, mitral stenosis, or tricuspid regurgitation don’t typically cause a true carotid bruit. In practice, a bruit heard over the carotids is most consistent with carotid stenosis from atherosclerosis, even though aortic valve disease can have radiation of heart sounds that reach the neck.