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Carotid Bruit question
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Carotid Bruit question

I am a health 40 year old woman with no history of high cholesterol or high blood pressure.  I recently went to my PCP for a one year check up and she discovered a carotid bruit on my right side of my neck.  She suggested I go to my cardiologist for a follow-up.  I do have a mild MV, which I've had since a child.  He examined me and also heard the articulation in my neck saying that it definitely sounds like a bruit.  He sent me a doppler yesterday and that was normal.  I'm going for an echo next week.  My mitral valve is very mild and hasn't changed over the years.  When my doctor received the report, he was kind of surprised.  What elese can it be?  Can you hear a bruit and have it be some other crazy diagnosis of something that I am not aware of?  Please provide some info.  I appreciate it.
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Carotid bruits aren't always associated with stenoses (blockages), especially in a young healthy patient.  I would not expect to find anything there on the US, but I would still get one to be certain.  Bruits are caused by turbulent blood flow which usually occurs at the branching points of the arteries.  The carotid artery splits into two arteries at the level of the neck.  There are also other conditions that could cause bruits as well.  One has to rule out arotic valve stenosis and hypertrophic cardiomyopathy ( I am certain you don't have that based on your exam, and an echocardiogram will prove that).  There could also be a blockage in the arteries before then neck such as the bracheocephalic trunk.  This is extremely unusual and would be associated with symptoms in the right arm.  So based on all this, I think it is reasonable to have an echocardiogram to make sure that all the valves and the heart muscle are normal.  If the neck US is normal and you have no symptoms, you should be reassured and check again in a few years.
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