From the Guidelines
It is normal to hear heart sounds in the carotid area, but the presence of a loud or abnormal murmur may indicate underlying cardiovascular pathology, such as aortic stenosis, which requires further evaluation with echocardiography as recommended by guidelines 1. When auscultating the carotid arteries, you may hear transmitted heart sounds because the carotid arteries are directly connected to the heart and are relatively large vessels that can conduct sound effectively. The first heart sound (S1) and second heart sound (S2) can often be heard, though they are typically softer than when auscultated directly over the heart. Some key points to consider when evaluating heart sounds in the carotid area include:
- The classic findings of a loud, late-peaking systolic murmur that radiates to the carotids, a single or paradoxically split second heart sound (S2), and a delayed and diminished carotid upstroke confirm the presence of severe aortic stenosis, as noted in guidelines 1.
- Echocardiography is indicated when there is a systolic murmur that is grade 3/6 or greater, a single S, or symptoms that might be due to aortic stenosis, and is recommended for the diagnosis and assessment of aortic stenosis severity, as well as for re-evaluation of patients with known aortic stenosis and changing symptoms or signs 1.
- The only physical examination finding that is reliable in excluding the possibility of severe aortic stenosis is a normally split second heart sound, highlighting the importance of careful physical examination and further diagnostic testing when abnormalities are detected 1.
From the Research
Heart Sounds on Carotid Area
- The provided studies do not directly address the normality of hearing heart sounds on the carotid area 2, 3, 4, 5, 6.
- However, the studies discuss the importance of cardiac examination and echocardiography in evaluating systolic murmurs and valvular heart disease 2, 3, 4, 5, 6.
- The carotid area is not specifically mentioned as a typical location for hearing heart sounds, but the studies emphasize the significance of auscultation and physical examination in detecting cardiac abnormalities 4, 5, 6.
- It is essential to note that the presence of heart sounds on the carotid area may be related to various factors, including the patient's anatomy, the examiner's technique, and the underlying cardiac condition 2, 3.
- Further research is needed to determine the normality of hearing heart sounds on the carotid area, as the provided studies do not provide a clear answer to this question 2, 3, 4, 5, 6.
Related Findings
- The studies highlight the importance of echocardiography in evaluating systolic murmurs and valvular heart disease 2, 3, 5, 6.
- The diagnostic accuracy of cardiac examination is limited, especially in cases with multiple lesions or complex cardiac conditions 2, 3, 6.
- Clinical context, symptom status, and prior knowledge of diagnosis can influence the detection of cardiac murmurs and the interpretation of physical examination findings 4.