Watson's water hammer pulse

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.

Eponym

"Watson's water hammer pulse" and "Corrigan's pulse" refer to similar observations. However, the former usually refers to measurement of a pulse on a limb, while the latter refers to measurement of the pulse of the carotid artery.

"Corrigan's pulse" is named for Sir Dominic Corrigan, the Irish physisian, who characterized it in 1832.
"Watson's water hammer pulse" is named for Thomas Watson, who characterized it in 1844.

Observation

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 water hammer 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.

Causes

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

1. Physiological Fever
Pregnancy
2. Cardiac lesions Aortic regurgitation
Patent ductus arteriosus
Systolic hypertension
Bradycardia
Aortopulmonary window
Rupture of sinus of Valsalva into heart chambers
3. Syndromes or High output states Anemia
Cor pulmonale
Cirrhosis of liver
Beriberi
Thyrotoxicosis
Arteriovenous fistula
Paget's disease'''
4. Other causes Chronic alcoholism

Translation of "Watson's water hammer pulse"

German: Wasserhammerpuls, Polish: Tętno Corrigana.