What can be expected during a physical examination of a patient with suspected renal artery stenosis?

During a physical examination of a patient with suspected renal artery stenosis, the presence of a bruit over the renal artery is a significant finding. A bruit is an abnormal sound or murmur heard over an artery due to turbulent blood flow, which can occur when there is a narrowing or obstruction in the artery. In the case of renal artery stenosis, the turbulence created by the altered blood flow can easily be detected with a stethoscope placed over the area of the renal artery, typically located in the flank region of the abdomen.

The detection of a bruit can help support the diagnosis of renal artery stenosis, indicating hemodynamic changes resulting from the narrowing of the artery. This finding, along with clinical history and possibly imaging studies, can guide further diagnostic and therapeutic measures to manage the condition, which can lead to secondary hypertension and renal impairment if not addressed.

In contrast, decreased abdominal girth, soft tissue swelling, and increased bowel sounds do not directly relate to the physical examination findings associated with renal artery stenosis and would not be expected findings in this context.