Watson's water hammer pulse

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Watson's Water Hammer Pulse

Watson's water hammer pulse, also known as Corrigan's pulse, is a medical sign characterized by a bounding and forceful pulse with a rapid rise and fall. It is typically associated with aortic regurgitation, a condition where the aortic valve does not close properly, allowing blood to flow back into the left ventricle of the heart during diastole.

Pathophysiology[edit | edit source]

The water hammer pulse is a result of the increased stroke volume and rapid ejection of blood from the left ventricle into the aorta, followed by a rapid fall in pressure as the blood regurgitates back into the ventricle. This creates a pulse that is both strong and quick, resembling the action of a water hammer, a phenomenon in plumbing where a sudden stop in water flow causes a loud banging noise.

In aortic regurgitation, the left ventricle must accommodate the regurgitant volume in addition to the normal venous return, leading to volume overload. Over time, this can cause left ventricular dilation and hypertrophy.

Clinical Presentation[edit | edit source]

Patients with aortic regurgitation may present with:

  • Bounding pulse: The pulse is described as "collapsing" or "water hammer" due to its rapid upstroke and downstroke.
  • Wide pulse pressure: The difference between systolic and diastolic blood pressure is increased.
  • Other signs: These may include a diastolic murmur heard best at the left sternal border, and signs of left heart failure such as dyspnea and fatigue.

Diagnosis[edit | edit source]

The diagnosis of aortic regurgitation and the presence of a water hammer pulse is typically made through:

  • Physical examination: Palpation of the radial or carotid pulse may reveal the characteristic bounding nature.
  • Echocardiography: This imaging modality can confirm the presence of aortic regurgitation and assess the severity of the condition.
  • Cardiac catheterization: In some cases, this may be used to measure pressures and assess the degree of regurgitation.

Management[edit | edit source]

Management of aortic regurgitation and the associated water hammer pulse depends on the severity of the condition and the presence of symptoms. Options include:

  • Medical therapy: Vasodilators such as ACE inhibitors or calcium channel blockers may be used to reduce afterload and improve forward flow.
  • Surgical intervention: In severe cases, aortic valve replacement or repair may be necessary.

History[edit | edit source]

The term "water hammer pulse" was coined by Sir Dominic John Corrigan, an Irish physician, in the 19th century. The name "Corrigan's pulse" is often used interchangeably with "water hammer pulse."

Also see[edit | edit source]


Cardiovascular disease A-Z

Most common cardiac diseases

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Contributors: Prab R. Tumpati, MD