A Centenary of Auscultatory Blood Pressure Measurement: A Tribute to Nikolai Korotkoff

Abstract

In 1905, Dr. Nikolai Korotkoff (1874–1920), a Russian surgeon, discovered a simple and precise technique to measure arterial pressure. He was born on 26th February 1874 in the central Russian city of Kursk. Korotkoff graduated from the Medical Faculty of Moscow University in 1898, but he worked later in the Surgical Clinic at the Imperial Military Medical Academy in St. Petersburg (Russia). Korotkoff served as a military surgeon during the Russo-Japanese War (1904–1905) and his major efforts were to find reliable clinical signs that could predict whether limb flow would be viable after vascular surgery of traumatic aneurysm. He found that after complete compression, the aneurysm of the arm (i.e. distal pulse on a. brachialis) disappeared with Riva-Rocci cuff and then gradually decreasing the pressure, a series of sounds could be heard by stethoscope under the artery distal to the compression. Korotkoff described four distinct phases of sounds: first sound, then compression murmurs, second tone, and disappearance of sounds. Korotkoff was also able to demonstrate the same auscultatory finding in healthy persons. He failed to notice only the muffled second sound, which was demonstrated a little later. These classical observations are now well known as the five different phases of Korotkoff sounds. In November 1905, during a conference of the Imperial Military Medical Academy, he reported his discovery in a short presentation entitled ‘On the issue of the methods for measuring blood pressure’. In 1939, the Joint Committee of the American Heart Association and the Cardiac Society of Great Britain and Ireland recognized officially and accepted worldwide Korotkoff’s method for blood pressure determining.