Bruit De Diable

BRUIT DE DIABLE (syn.: hum of the spinner, hum of the nuns), a venous noise heard over the bulbus v. jugularis, between the sternal and clavicular parts of the m. sterno-cleidomastoideus, better heard when the patient is standing, on the right side. In clearly expressed cases, it has a continuous character, increasing rhythmically corresponding to the systole and diastole of the heart and during inspiration; a not sharply expressed noise may be heard only during systolic and diastolic intensification. It is observed most often in anemics. While some authors attribute to it considerable diagnostic importance (Sahli), others (Eichhorst) consider it a physiological phenomenon having no significance. The occurrence of the noise is associated with a decrease in viscosity and acceleration of blood flow; a favorable factor is the sudden expansion of the vessel bed when the v. jugularis passes into the bulbus venae jugularis; similarly, such a noise is more rarely heard also over other veins (subclavian, brachial, etc.).