Corrigan’s pulse is a jerky, bounding arterial pulse characterized by a rapid upstroke followed by a sudden collapse. It is most prominently detected in the carotid or radial arteries. Clinically, it is associated with aortic valve insufficiency (regurgitation) but may also appear in other cardiovascular conditions.

Pathophysiology

• Aortic insufficiency leads to regurgitation of blood from the aorta into the left ventricle during diastole.

• This causes increased stroke volume and a high systolic pressure, followed by a rapid decline in diastolic pressure.

• The resulting pulse is described as “water-hammer” or collapsing:

  • Rapid upstroke: due to increased stroke volume.

  • Abrupt collapse: due to sudden backflow of blood.

• Similar hemodynamic patterns may be seen in:

  • Severe anemia (reduced blood viscosity)

  • Patent ductus arteriosus

  • Coarctation of the aorta

  • Systemic arteriosclerosis (in advanced cases)

Examination Technique

Patient Positioning

• Have the patient sit or stand comfortably.

• Raise the patient’s arm above the head to enhance arterial pulsation.

Palpation

• Place fingers on the carotid artery (or radial artery).

• Observe and feel for:

  • Strong, rapid upstroke

  • Sudden collapse

• Assess bilaterally to detect asymmetry.

Adjunct Assessment

• Measure blood pressure to correlate with pulse amplitude and character.

• Perform cardiac auscultation for murmurs of aortic regurgitation.

Clinical Features

Differential Diagnosis

Pediatric considerations

• Corrigan’s pulse in children may indicate congenital heart disease (e.g., PDA, bicuspid aortic valve with regurgitation).

• Early detection is crucial to prevent heart failure or pulmonary hypertension.

Geriatric considerations

• Arterial stiffening and coexisting atherosclerosis may alter the pulse character, making detection more difficult.

• Corrigan’s pulse remains a useful clinical sign for aortic insufficiency.

Limitations

• Subtle or absent in mild aortic regurgitation or in patients with low cardiac output.

• Can be masked by obesity, edema, or peripheral arterial disease.

• Should be interpreted alongside auscultation, imaging, and hemodynamic assessment.

Patient counseling

• Explain that the jerky pulse is a marker of heart valve dysfunction or other cardiovascular conditions.

• Stress the importance of cardiology evaluation, especially if associated with chest pain, dyspnea, or palpitations.

• Discuss possible investigations (echocardiography) and treatment options, including medical management or surgical repair if indicated.

Conclusion

Corrigan’s pulse is a classical cardiovascular sign indicating high stroke volume with rapid systolic upstroke and abrupt diastolic collapse, most commonly due to aortic regurgitation. Accurate detection, combined with auscultatory and imaging findings, aids early diagnosis and management of underlying cardiac pathology.

References

1. Corrigan W. On permanent patency of the aortic orifice of the heart. Edinburgh Med Surg J. 1832;38:103–114.

2. Braunwald E, Zipes DP, Libby P. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia: Elsevier; 2019.

3. Otto CM. Textbook of Clinical Echocardiography. 5th ed. Philadelphia: Elsevier; 2018.

4. Lilly LS. Pathophysiology of Heart Disease: A Collaborative Project of Medical Students and Faculty. 6th ed. Philadelphia: Wolters Kluwer; 2016.

5. American College of Cardiology / American Heart Association Guidelines. Management of Valvular Heart Disease. Circulation. 2020;141:e35–e71.