Watson's water hammer pulse

Watson's water hammer pulse

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

Synonyms and Keywords: Corrigan's 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.

Palpation

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.

Causes

Physiological:

• Fever
• Pregnancy

Cardiac lesions:

• Aortic regurgitation
• Patent ductus arteriosus
• Systolic hypertension
• Bradycardia
• Aortopulmonary window
• Rupture of the sinus of valsalva into heart chambers

Syndromes or High output states:

• Anemia
• Cor pulmonale
• Cirrhosis of liver
• Beriberi
• Thyrotoxicosis
• Arteriovenous fistula
• Paget's disease

Other causes:

• Chronic alcoholism

Videos

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

Related Chapters

• Aortic Insufficiency Physical Examination
• Blood hammer

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