Carotid artery stenosis a physician detects a carotid bruit, or murmur, over the carotid artery by listening through a stethoscope during a physical exam. For people with symptoms, the American Heart Association recommends initial screening using ultrasound (see diagnosis below). Carotid artery stenosis is usually diagnosed by color flow duplex ultrasound scan of the carotid arteries in the neck. This involves no radiation, no needles and no contrast agents that may cause allergic reactions. This test has good sensitivity and specificity. Typically duplex ultrasound scan is the only investigation required for decision making in carotid stenosis as it is widely available and rapidly
Carotid bruit Carotid bruit A carotid bruit is a vascular murmur sound (bruit) heard over the carotid artery area on auscultation during systole. It may occur as the result of carotid artery stenosis (though some disagree); however, most carotid bruits, particularly those found in younger or asymptomatic patients, are not related to any disease and are termed "innocent carotid bruits". A carotid bruit is unlikely to be heard if the stenosis occludes less than 40% of the diameter of the artery. Likewise, a stenosis of greater than 90% may not be heard, as the flow may be too low. Many carotid bruits