Levine's sign is a clenched fist held over the
chest
The thorax (: thoraces or thoraxes) or chest is a part of the anatomy of 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 di ...
to describe
ischemic
Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems ...
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 (1891–1966), an influential American
cardiologist
Cardiology () is the study of the heart. 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 di ...
, 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 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 located pressure-like chest pain, ...
(
myocardial infarction
A myocardial infarction (MI), commonly known as a heart attack, occurs when Ischemia, blood flow decreases or stops in one of the coronary arteries of the heart, causing infarction (tissue death) to the heart muscle. The most common symptom ...
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 part ...
).
A variant of this sign, which uses the entire palm instead of the clenched fist over the chest, is commonly known as the ''palm sign'', and in Latin America it is widely referred to as Cossio's Sign, Cossio-Levine Sign or Fuchs-Levine Sign. Argentine cardiologist
Pedro Alurralde Cossio (1900-1986) who described the sign in 1934. Brazilian cardiologist Flávio Danni Fuchs (1950-) is also attributed as having described the sign.
References
Symptoms and signs: Cardiac
{{med-sign-stub