Abstract
Arterial bruit was auscultated over the eyeball, carotid and femoral areas in 1050 patients aged 40 to 88 years (average 63 years) and the relationship between ocular bruit and ischemic stroke and other atherosclerotic diseases was studied. Ocular bruit was detected in 43 of the 1050 patients (4%) and in 25 of 300 patients aged 70 or more (8%). Not only ischemic stroke but ischemic heart disease, intermittent claudication, hypertension and diabetes mellitus were significantly more prevalent in patients with ocular bruit than in those without. The incidence of carotid or femoral bruit and roentgenologic calcification of the aortic arch, abdominal aorta and carotid sinus were also significantly higher in patients with ocular bruit than in those without.
Dynamic responses of ocular bruits to various maneuvers were evaluated by recording them with a phonocardiograph. Leg-raising, paperbag rebreathing, contralateral carotid compression or inhalation of amyl nitrite resulted in augmentation of the bruits in over 70% of patients. Arrhythmias such as ectopic beats or atrial fibrillation induced a beat-to-beat change of the bruits.
In conclusion, ocular bruits were not rare in older patients and there was a close relationship between the bruits and generalized atherosclerosis. Ocular auscultation is useful not only in the evaluation of neurologic patients, but also in the recognition of asymptomatic cerebral atherosclerosis.
