Physical exam myths: listening for carotid artery bruits in stroke patients.
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.
Nemeth
Joe
J
Division of Emergency Medicine, Montreal General Hospital, Montreal Children's Hospital, Montréal, Quebec, Canada. joe.nemeth@mcgill.ca
D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology