Question

Water hammer pulse (Corrigan's pulse) is seen in:

• A. Aortic regurgitation
• B. Mitral stenosis
• C. Aortic stenosis
• D. Left ventricular failure

Hint:

Which lesion gives a wide pulse pressure with a sharp rise and collapse?

Answer 1

The Correct Option is A

Answer: Aortic regurgitation.
Step 1: Water hammer (collapsing or Corrigan's) pulse is a large, bounding pulse that strikes the finger with a quick forceful jerk and then collapses suddenly. It is best appreciated by elevating the patient's arm and feeling the radial artery.
Step 2: The mechanism is a wide pulse pressure. In chronic aortic regurgitation the left ventricle ejects a large stroke volume (raising systolic pressure) while blood leaks back into the ventricle during diastole (dropping diastolic pressure). The result is a rapid rise and rapid fall, that is, a collapsing pulse.
Step 3: Why not the others. Aortic stenosis gives the opposite, a slow-rising, low-volume pulse (pulsus parvus et tardus). Mitral stenosis gives a low-volume pulse and possibly atrial fibrillation. LV failure gives a low-volume, sometimes alternating pulse. Only aortic regurgitation produces the wide pulse pressure that makes a water hammer pulse.
Ref: Hutchison's Clinical Methods, 24e.