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Hamman's sign (rarely, Hammond's sign [1] or Hammond's crunch [2]) is a medical sign consisting of a crunching, rasping sound, synchronous with the heartbeat, [3] heard over the precordium in spontaneous mediastinal emphysema. It is thought to result from the heart beating against air-filled tissues.
Emphysema is a respiratory disease of the lower respiratory tract. [7] It is commonly caused by tobacco smoking but some people are affected who have never smoked. [14] The presence of emphysema is a clear risk factor for lung cancer, made stronger in those who smoke. [20] Early symptoms of emphysema vary.
Signs and symptoms of spontaneous subcutaneous emphysema vary based on the cause, but it is often associated with swelling of the neck and chest pain, and may also involve sore throat, neck pain, difficulty swallowing, wheezing and difficulty breathing. [5] Chest X-rays may show air in the mediastinum, the middle of the chest cavity. [5]
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Hamman's syndrome, also known as Macklin's syndrome, is a syndrome of spontaneous subcutaneous emphysema [1] (air in the subcutaneous tissues of the skin) and pneumomediastinum (air in the mediastinum, the center of the chest cavity), sometimes associated with pain and, less commonly, dyspnea (difficulty breathing), dysphonia, and a low-grade fever.
Combined pulmonary fibrosis and emphysema (CPFE), describes a medical syndrome involving both pulmonary fibrosis and emphysema. [ 1 ] [ 2 ] The combination is most commonly found in male smokers. Pulmonary function tests typically show preserved lung volume with very low transfer factor.
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A diver with symptoms of mediastinal emphysema may also have any combination of arterial gas embolism, pneumothorax and subcutaneous or pulmonary interstitial emphysema. Factors which may prevent free escape of the compressed breathing gas include holding the breath or respiratory obstructions such as cysts, mucus plugs, or scar tissue. [10]