Which finding is most suggestive of an arteriovenous shunt?

Which finding is most suggestive of an arteriovenous shunt?

• A. Murmur
• B. Bruit or thrill
• C. Pulsatile mass
• D. Rest pain

Answer: (B)

An arteriovenous shunt creates a direct artery-to-vein connection, producing high-velocity, turbulent flow. The most direct clues are a bruit, an audible sound from that turbulence, and a thrill, a palpable vibration over the vessel. These signs are characteristic of an AV shunt because they reflect the unusually high flow and rapid jet of blood entering the venous system. Rest pain is a sign of ischemia and not specific to shunts, and a pulsatile mass can occur with various vascular issues but isn’t as specific as the presence of a bruit or thrill. Murmur can be heard in many conditions, but the combination of a bruit or thrill is the strongest, most specific indicator of an arteriovenous shunt.

An arteriovenous shunt creates a direct artery-to-vein connection, producing high-velocity, turbulent flow. The most direct clues are a bruit, an audible sound from that turbulence, and a thrill, a palpable vibration over the vessel. These signs are characteristic of an AV shunt because they reflect the unusually high flow and rapid jet of blood entering the venous system. Rest pain is a sign of ischemia and not specific to shunts, and a pulsatile mass can occur with various vascular issues but isn’t as specific as the presence of a bruit or thrill. Murmur can be heard in many conditions, but the combination of a bruit or thrill is the strongest, most specific indicator of an arteriovenous shunt.