A 58-year-old man with severe chronic aortic regurgitation is examined. Which combination of peripheral signs correctly matches the mechanism of a rapidly collapsing arterial pulse?
- A Pulsus alternans: beat-to-beat variation in amplitude due to severe LV dysfunction
- B Pulsus paradoxus: inspiratory fall in systolic pressure exceeding 10 mmHg
- C Corrigan pulse: rapid upstroke and collapse due to large stroke volume with diastolic run-off ✓
- D Pulsus bisferiens: two systolic peaks seen only in hypertrophic cardiomyopathy
Correct answer: C. Corrigan pulse: rapid upstroke and collapse due to large stroke volume with diastolic run-off
Explanation
Chronic aortic regurgitation produces a high stroke volume ejected into a low-diastolic-pressure bed because blood runs back into the LV and the periphery. This gives Corrigan's water-hammer pulse with wide pulse pressure. Bisferiens also occurs in significant AR (combined with AS), so option D is wrong in restricting it to HCM. Pulsus paradoxus suggests tamponade and pulsus alternans severe LV failure; neither reflects diastolic run-off.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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