Presence of a bruit or thrill in a vessel is suggestive of which condition?

• A. Thrombosis
• B. Aneurysm
• C. Arteriovenous shunt
• D. Hemangioma

Answer: (C)

Presence of a bruit or thrill over a vessel points to high-flow, turbulent blood movement caused by an abnormal artery-to-vein connection. This is most characteristic of an arteriovenous shunt (such as a fistula or graft), where arterial blood is channeled directly into the venous system. The shunt creates brisk, turbulent flow that can be heard as a bruit with a stethoscope and felt as a thrill with a fingertip. On ultrasound, you'd expect arterialized venous flow and high-velocity, low-resistance waves in the feeding artery, reflecting the abnormal connection.

Thrombosis, by contrast, usually leads to absent or markedly reduced flow rather than turbulence. An aneurysm is a dilated vessel and can have turbulent flow, but a persistent bruit or thrill is not the defining sign. A hemangioma is a vascular lesion that may show internal flow on Doppler but does not characteristically produce a palpable thrill or audible bruit over the vessel. Thus, the presence of a bruit or thrill most strongly indicates an arteriovenous shunt.