- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
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Sheldon G. Sheps, M.D.
Sheldon G. Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Hypertension Division in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," he says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and participated in the fourth, fifth and seventh groups, that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals. He has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material and joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure,'' published in 2008.
He was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee, National High Blood Pressure Education Program, and was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Question
Carotid bruit: What causes it?
At my last physical exam, my doctor said he heard a bruit over my carotid artery. Is this serious?
Answer
from Sheldon G. Sheps, M.D.
A bruit (bru-we) is an abnormal and often harsh sound heard with a stethoscope over a blood vessel, usually an artery. The sound, which is synchronous with your heartbeat, is caused by turbulent blood flow, such as caused by irregularities in the wall of the blood vessel or by an abnormal connection (fistula) between an artery and vein. A bruit heard over the carotid artery (carotid bruit) may indicate fatty buildup in the wall of the vessel (atherosclerosis).
Sometimes a bruit is only temporary and goes away on its own. Treatment of the underlying cause, when possible, may make the bruit go away.
If the bruit in your carotid artery is caused by atherosclerosis, you have an increased risk of clogged arteries and stroke. Your doctor may prescribe medications to help prevent clotting and recommend aggressive treatment of high cholesterol, high blood pressure and diabetes, if present. Also, if you smoke, you should stop.
If your carotid artery is more than 50 percent blocked, surgery to remove the fatty buildup (endarterectomy) or to open the narrowed artery (angioplasty and perhaps stenting) may be necessary.
