Levine's sign is a clenched fist held over the

chest The thorax or chest is a part of the anatomy of humans, mammals, and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions of the crea ...

to describe ischemic

chest pain Chest pain is pain or discomfort in the chest, typically the front of the chest. It may be described as sharp, dull, pressure, heaviness or squeezing. Associated symptoms may include pain in the shoulder, arm, upper abdomen, or jaw, along with n ...

. It is named for

Samuel A. Levine Samuel Albert Levine (January 1, 1891 – March 31, 1966) was an American cardiologist. The Levine scale, Levine's sign and Lown–Ganong–Levine syndrome are named after him. The Samuel Albert Levine Cardiac Unit at Brigham and Women's Hospita ...

(1891–1966), an influential American

cardiologist Cardiology () is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular hear ...

, who first observed that many patients with chest pain made this same sign to describe their symptoms. This clenched fist signal may be seen in patients with

acute coronary syndrome Acute coronary syndrome (ACS) is a syndrome (a set of signs and symptoms) due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. The most common symptom is centrally loca ...

(

myocardial infarction A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may ...

and

angina pectoris Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium). It is most commonly a symptom of coronary artery disease. Angina is typically the result of obstru ...

). A variant of this sign which uses the entire palm instead of the clenched fist over the

is commonly known as the ''Palm Sign'' and in Latin America, it is widely referred to as the Cossio's Sign, Cossio-Levine Sign or even Fuchs-Levine Sign. The first two in reference of famous Argentine Cardiologist, Pedro Alurralde Cossio (1900-1986) who described it sometime in 1934. The latter in reference of famous Brazilian Cardiologist, Flávio Danni Fuchs (1950-), also attributed as having described the sign

References

Symptoms and signs: Cardiac {{med-sign-stub