Corrigan’s Pulse and Quincke’s Pulse 水冲脉 毛细血管搏动征

A 58-year-old man was referred to the cardiology clinic for evaluation of exertional dyspnea. Twelve years before presentation, he had undergone a bioprosthetic aortic-valve replacement for treatment of severe bicuspid aortic stenosis and for repair of an ascending aortic aneurysm. 

58岁男患因劳力性呼吸困难就诊，12年前患者因重度主动脉瓣狭窄行生物瓣膜置换术，升主动脉瘤修补术。

On physical examination, his blood pressure was 142/57 mm Hg. Auscultation revealed systolic and diastolic murmurs that had a prominent holodiastolic component. While the patient was sitting upright, the right carotid artery was visibly pulsatile, with systolic swelling and rapid diastolic collapse — a sign known as Corrigan’s pulse (Panel A, arrow, and Video 1). 

查体 患者血压 142/57 mm Hg，心脏听诊可闻及收缩期及全舒张期杂音。患者坐立状态下可见右颈总动脉搏动，收缩期充盈，舒张期塌陷，即水冲脉。

The tips of the patient’s index finger and thumb as well as the nail bed of the thumb exhibited capillary pulsation — a sign known as Quincke’s pulse (Panel B, arrow, and Video 2). 

患者食指及拇指末梢及甲床呈现毛细血管搏动征。

Corrigan’s pulse and Quincke’s pulse are two findings of chronic severe aortic regurgitation and are manifestations of a wide pulse pressure with large systolic stroke volume and rapid fall in arterial pressure. 

水冲脉及毛细血管搏动征见于慢性重度主动脉返流，见于脉压差明显增大及收缩期心搏量明显增加，继而舒张压迅速下降。

Echocardiography revealed a left ventricular ejection fraction of 56%, an end-systolic diameter of 46 mm (an increase from 36 mm measured in the previous year), and severe regurgitation of the prosthetic aortic valve. Because of progressive left ventricular dilatation and exertional dyspnea, the patient underwent valve-in-valve transcatheter aortic-valve replacement. The patient’s dyspnea resolved after the procedure, and he is currently doing well.

心超提示左室射血分数56%，左室收缩末径46mm，较去年36mm增宽，人工瓣重度返流。鉴于患者进行性的左室扩张及劳力性呼吸困难，患者予经导管主动脉瓣置换。术后患者呼吸困难缓解，恢复良好。

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https://interactive.nejm.org/iv/numbered/index.html?media_id=Y8s173xY&fixed=true

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