Watson's water hammer pulse: Difference between revisions

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VisualWikitext

Latest revision as of 13:34, 11 December 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Ogheneochuko Ajari, MB.BS, MS [3]

Synonyms and keywords: Corrigan's pulse, collapsing pulse, cannonball pulse, hyperkinetic pulse

Overview

Watson's water hammer pulse is the medical sign which describes a pulse that is bounding and forceful, as if it were the hitting of a water hammer that was causing the pulse. This is associated with increased stroke volume of the left ventricle and decrease in the peripheral resistance leading to the widened pulse pressure of aortic regurgitation. Also, the carotid pulsations seen in aortic regurgitation is known as Corrigan's pulse.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. There are no known life threatening causes of Watson's water hammer pulse that would result in death or permanent disability if not treated within 24 hours.

Common Causes

Causes by Organ System

Cardiovascular	Aortic regurgitation, aortopulmonary window, arteriovenous fistula, beriberi, bradycardia, complete heart block, cor pulmonale, leaking aortic valve prosthesis, mitral regurgitation, Paget's disease, patent ductus arteriosus, rupture of sinus of valsalva, systolic hypertension, truncus arteriosus, ventricular septal defect
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	Hyperthyroidism, thyrotoxicosis
Environmental	Heat
Gastroenterologic	Beriberi, cirrhosis of liver
Genetic	No underlying causes
Hematologic	Anemia
Iatrogenic	No underlying causes
Infectious Disease	Fever
Musculoskeletal / Ortho	Paget's disease
Neurologic	No underlying causes
Nutritional / Metabolic	Beriberi, chronic alcoholism
Obstetric/Gynecologic	Pregnancy
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	Anxiety, emotion
Pulmonary	Cor pulmonale
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Chronic alcoholism, exercise, fever, heat

Causes in Alphabetical Order

Physical Examination

To feel a water hammer pulse with the patient reclining, the examiner raises the patient's arm vertically upwards. The examiner grasps the muscular part of the patient's forearm. A waterhammer pulse is felt as a tapping impulse which is transmitted through the bulk of the muscles. This happens because the blood that is pumped to the arm during systole is emptied very quickly due to the gravity effect on the raised arm. This results in the artery emptying back into the heart during diastole, therefore causing a palpable pulse.

This is commonly found when a patient has a leaking prosthetic aortic valve.

Videos

Video demonstrating Corrigan's sign (rapid upstroke and collapse of the carotid artery pulse) {{#ev:youtube|C6mTmpP9Lvw}}

Related Chapters

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 ^1.5 ^1.6 ^1.7 ^1.8 ^1.9 Suvarna JC (2008). "Watson's water hammer pulse". J Postgrad Med. 54 (2): 163–5. PMID 18480541.

Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs

Template:WH Template:WS

[pmid18480541-1] 1.0 ^1.1 ^1.2 ^1.3 ^1.4 ^1.5 ^1.6 ^1.7 ^1.8 ^1.9 Suvarna JC (2008). "Watson's water hammer pulse". J Postgrad Med. 54 (2): 163–5. PMID 18480541.

[1]

v t e Symptoms and signs: circulatory (R00–R03, 785)
Cardiovascular	Template:Navbox subgroup
Myeloid/blood	Template:Navbox subgroup

v t e Symptoms and signs: respiratory system (R04–R07, 786)
Hemorrhage	Epistaxis Hemoptysis
Abnormalities of breathing	Respiratory sounds Stridor Wheeze Crackles Rhonchi Hamman's sign Apnea Dyspnea Hyperventilation/Hypoventilation Hyperpnea/Tachypnea/Hypopnea/Bradypnea Orthopnea/Platypnea Trepopnea Biot's respiration Cheyne-Stokes respiration Kussmaul breathing Hiccup Mouth breathing/Snoring Breath-holding
Other	Asphyxia Cough Pleurisy Sputum Respiratory arrest Hypercapnia/Hypocapnia Pectoriloquy: Whispered pectoriloquy Egophony Bronchophony Pleural friction rub Fremitus Silhouette sign
Chest, general	Chest pain Precordial catch syndrome

v t e Symptoms and signs: digestive system and abdomen (R10–R19, 787,789)
GI tract	Template:Navbox subgroup
Accessory	Hepatosplenomegaly/Hepatomegaly Jaundice
Abdominopelvic	Ascites
Abdominal – general	Abdominal pain (Acute abdomen, Colic, Baby colic) Splenomegaly Abdominal guarding · Abdominal mass · Rebound tenderness Shifting dullness · Bulging flanks · Puddle sign · Fluid wave test

v t e Symptoms and signs: Symptoms concerning nutrition, metabolism and development (R62–R64, 783)
Ingestion/Weight	decrease: Anorexia • Weight loss/Cachexia/Underweight increase: Polyphagia • Polydipsia • Orexigenia • Weight gain
Growth	Delayed milestone • Failure to thrive • Short stature (e.g., Idiopathic)

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{SI}}
-{{CMG}}; {{AOEIC}} {{CZ}}
+{{CMG}}; {{AOEIC}} {{CZ}} {{Ochuko}}
-{{SK}} Corrigan's pulse
+{{SK}} Corrigan's pulse, collapsing pulse, cannonball pulse, hyperkinetic pulse
 ==Overview==
@@ Line 9: / Line 9: @@
 ==Causes==
-===Physiological:===
+===Life Threatening Causes===
-* [[Fever]]
+Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.  There are no known life threatening causes of Watson's water hammer pulse that would result in death or permanent disability if not treated within 24 hours.
-* [[Pregnancy]]
-===Cardiac lesions:===
+===Common Causes===
-* [[Aortic regurgitation]]
+*[[Aortic regurgitation]]
-* [[Patent ductus arteriosus]]
+*[[Fever]]
-* [[Systolic hypertension]]
+*[[Pregnancy]]
-* [[Bradycardia]]
-* Aortopulmonary window
-* Rupture of the sinus of valsalva into heart chambers
-===Syndromes or High output states:===
+===Causes by Organ System===
-* [[Anemia]]
-* [[Cor pulmonale]]
-* [[Cirrhosis of liver]]
-* [[Beriberi]]
-* [[Thyrotoxicosis]]
-* [[Arteriovenous fistula]]
-* [[Paget's disease]]
-===Other causes:===
+{|style="width:80%; height:100px" border="1"
-* Chronic alcoholism
+|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
+|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Aortic regurgitation]], [[aortopulmonary window]], [[arteriovenous fistula]], [[beriberi]], [[bradycardia]], [[complete heart block]], [[cor pulmonale]], [[leaking aortic valve prosthesis]], [[mitral regurgitation]], [[Paget's disease]], [[patent ductus arteriosus]], [[rupture of sinus of valsalva]], [[systolic hypertension]], [[truncus arteriosus]], [[ventricular septal defect]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Chemical / poisoning'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Dermatologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Drug Side Effect'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Ear Nose Throat'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Endocrine'''
+|bgcolor="Beige"|[[Hyperthyroidism]], [[thyrotoxicosis]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Environmental'''
+|bgcolor="Beige"| [[Heat]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Gastroenterologic'''
+|bgcolor="Beige"|[[Beriberi]], [[cirrhosis of liver]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Genetic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Hematologic'''
+|bgcolor="Beige"| [[Anemia]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Iatrogenic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Infectious Disease'''
+|bgcolor="Beige"| [[Fever]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Musculoskeletal / Ortho'''
+|bgcolor="Beige"| [[Paget's disease]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Neurologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Nutritional / Metabolic'''
+|bgcolor="Beige"|[[Beriberi]], [[chronic alcoholism]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Obstetric/Gynecologic'''
+|bgcolor="Beige"|[[Pregnancy]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Oncologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Opthalmologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Overdose / Toxicity'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Psychiatric'''
+|bgcolor="Beige"|[[Anxiety]], [[emotion]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Pulmonary'''
+|bgcolor="Beige"|[[Cor pulmonale]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Renal / Electrolyte'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Rheum / Immune / Allergy'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Sexual'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Trauma'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Urologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Dental'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Miscellaneous'''
+|bgcolor="Beige"|[[Chronic alcoholism]], [[exercise]], [[fever]], [[heat]]
+|-
+|}
+===Causes in Alphabetical Order===
+{{col-begin|width=80%}}
+{{col-break|width=33%}}
+*[[Anemia]]
+*[[Anxiety]]
+*[[Aortic regurgitation]]
+*[[Aortopulmonary window]]<ref name="pmid18480541">{{cite journal| author=Suvarna JC| title=Watson's water hammer pulse. | journal=J Postgrad Med | year= 2008 | volume= 54 | issue= 2 | pages= 163-5 | pmid=18480541 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18480541  }} </ref>
+*[[Arteriovenous fistula]]
+*[[Beriberi]]
+*[[Bradycardia]]
+*[[Chronic alcoholism]]
+*[[Cirrhosis of liver]]
+*[[Complete heart block]] <ref name="pmid18480541">{{cite journal| author=Suvarna JC| title=Watson's water hammer pulse. | journal=J Postgrad Med | year= 2008 | volume= 54 | issue= 2 | pages= 163-5 | pmid=18480541 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18480541  }} </ref>
+*[[Cor pulmonale]]
+*[[Emotion]]<ref name="pmid18480541">{{cite journal| author=Suvarna JC| title=Watson's water hammer pulse. | journal=J Postgrad Med | year= 2008 | volume= 54 | issue= 2 | pages= 163-5 | pmid=18480541 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18480541  }} </ref>
+*[[Exercise]]<ref name="pmid18480541">{{cite journal| author=Suvarna JC| title=Watson's water hammer pulse. | journal=J Postgrad Med | year= 2008 | volume= 54 | issue= 2 | pages= 163-5 | pmid=18480541 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18480541  }} </ref>
+{{col-break|width=33%}}
+*[[Fever]]
+*[[Heat]]<ref name="pmid18480541">{{cite journal| author=Suvarna JC| title=Watson's water hammer pulse. | journal=J Postgrad Med | year= 2008 | volume= 54 | issue= 2 | pages= 163-5 | pmid=18480541 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18480541  }} </ref>
+*[[Hyperthyroidism]]
+*[[Leaking aortic valve prosthesis]] <ref name="pmid18480541">{{cite journal| author=Suvarna JC| title=Watson's water hammer pulse. | journal=J Postgrad Med | year= 2008 | volume= 54 | issue= 2 | pages= 163-5 | pmid=18480541 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18480541  }} </ref>
+*[[Mitral regurgitation]]<ref name="pmid18480541">{{cite journal| author=Suvarna JC| title=Watson's water hammer pulse. | journal=J Postgrad Med | year= 2008 | volume= 54 | issue= 2 | pages= 163-5 | pmid=18480541 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18480541  }} </ref>
+*[[Paget's disease]]
+*[[Patent ductus arteriosus]]
+*[[Pregnancy]]
+*[[Rupture of sinus of valsalva]]<ref name="pmid18480541">{{cite journal| author=Suvarna JC| title=Watson's water hammer pulse. | journal=J Postgrad Med | year= 2008 | volume= 54 | issue= 2 | pages= 163-5 | pmid=18480541 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18480541  }} </ref>
+*[[Systolic hypertension]]
+*[[Thyrotoxicosis]]
+*[[Truncus arteriosus]]<ref name="pmid18480541">{{cite journal| author=Suvarna JC| title=Watson's water hammer pulse. | journal=J Postgrad Med | year= 2008 | volume= 54 | issue= 2 | pages= 163-5 | pmid=18480541 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18480541  }} </ref>
+*[[Ventricular septal defect]]<ref name="pmid18480541">{{cite journal| author=Suvarna JC| title=Watson's water hammer pulse. | journal=J Postgrad Med | year= 2008 | volume= 54 | issue= 2 | pages= 163-5 | pmid=18480541 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18480541  }} </ref>
+{{col-end}}
 ==Physical Examination==
@@ Line 45: / Line 177: @@
 *[[Aortic insufficiency physical examination|Aortic Insufficiency Physical Examination]]
 *[[Blood hammer]]
+==References==
+{{Reflist|2}}
 {{Circulatory system pathology}}
 {{Symptoms and signs}}
-{{WikiDoc Help Menu}}
-{{WikiDoc Sources}}
 [[Category:Medical signs]]
 [[Category:Signs and symptoms]]
 [[Category:Cardiology]]
+[[Category:Crowdiagnosis]]
+{{WH}}
+{{WS}}