Physical exam myths: listening for carotid artery bruits in stroke patients
1Division of Emergency Medicine, Montreal General Hospital, Montreal Children's Hospital, Montréal, Quebec, Canada. joe.nemeth@mcgill.ca
Abstract:
When a patient presents to the emergency department with a neurologic deficit and a cerebrovascular event is included in the differential diagnosis, the classic recommendation is to examine the carotid artery and assess for the presence of a bruit. The diagnostic yield and utility of this practice has seldom been called into question. This critical appraisal will review the practice of listening for a carotid artery bruit (CAB) in suspected stroke patients and analyze its clinical utility, including the sensitivity and specificity of a CAB for detecting a significant lesion and the potential impact a CAB may have on the investigation and disposition of such patients.
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