The Rational Clinical Examination
David L. Simel, Drummond Rennie
Abdominal Bruits
David L. Simel, Lori Orlando
Make the Diagnosis: Abdominal Bruits
Topics Discussed:
abdominal bruit, criterion standard comparisons (diagnostic tests), make the diagnosis, renal artery stenosis
Excerpt:
"Patients without hypertension should not have auscultation for
asymptomatic renal artery bruits because bruits frequently are a
normal finding. The search for renal artery stenosis should be confined
to certain patient populations (see below). When present in these
populations, an abdominal bruit is the most useful physical examination
finding for assessment of renal artery stenosis. Approximately 1% to 5% of the general population
has renovascular disease. Approximately 20% of white patients
with medically refractory hypertension have renal artery stenosis...."
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