What causes Corrigan's sign (water-hammer pulse)?

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Last updated: February 8, 2025View editorial policy

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From the Guidelines

Corrigan's sign, also known as water-hammer pulse, is primarily caused by aortic regurgitation (AR).

Key Factors

  • This condition is characterized by the backflow of blood from the aorta into the left ventricle during diastole, leading to a sudden and forceful pulse 1.
  • The main causes of AR include idiopathic dilatation of the aorta, congenital abnormalities of the aortic valve, calcific degeneration, rheumatic disease, infective endocarditis, and systemic hypertension 1.
  • Disease of either the aortic leaflets or the aortic root can distort the leaflets and prevent their correct apposition, resulting in AR 1.

Associated Conditions

  • Other conditions that can lead to AR include Marfan syndrome, aortic dissection, collagen vascular disease, and syphilis 1.
  • The Carpentier's classification is used to describe the mechanism of AR, and careful aortic valve analysis is mandatory in patients with AR 1.

Clinical Implications

  • The water-hammer pulse is a key clinical feature of AR, and its presence can aid in the diagnosis of this condition 1.
  • Accurate diagnosis and management of AR are crucial to prevent complications and improve patient outcomes 1.

From the Research

Causes of Corrigan's Sign (Water-Hammer Pulse)

  • Corrigan's pulse is characterized by the abrupt distension and quick collapse of carotid arteries in aortic regurgitation 2
  • Water hammer pulse is the characteristic pulse observed in peripheral arteries, similar to Corrigan's pulse 2
  • Aortic regurgitation (AR) is a valvular disease that can cause Corrigan's sign, characterized by retrograde blood flow from the aorta to the left ventricle 3, 4, 5
  • The wide pulse pressure and systolic hypertension associated with AR can lead to peripheral physical findings such as bounding pulses, which are similar to Corrigan's sign 3
  • Another possible cause of a "water hammer" effect is a blunt cardiac trauma, such as a fall from height, which can cause cardiac rupture 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Water hammer and Corrigan's pulses.

Clinical case reports, 2022

Research

Aortic Regurgitation.

Current cardiology reports, 2019

Research

Aortic Regurgitation: Review of Current Management.

Dimensions of critical care nursing : DCCN, 2024

Research

Cardiac Rupture Due to a Fall from Height: The 'Water Hammer' Effect.

Aerospace medicine and human performance, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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