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Levine's sign is a clenched fist held over the chest to describe ischemic chest pain. [1]It is named for Samuel A. Levine (1891–1966), an influential American cardiologist, who first observed that many patients with chest pain made this same sign to describe their symptoms.
patient clenches fist over chest when asked to describe pain Lhermitte's sign: Jean Lhermitte: neurology: lesions of cervical cord dorsal columns or caudal medulla, MS, chemotherapy, Behçet's disease: electrical sensation down the back and into limbs with neck flexion or extension Liebermeister's rule: Carl von Liebermeister: internal medicine
Pain can also be in the side of the neck, the pectoral area below the clavicle, the armpit/axillary area, and the upper back (i.e., the trapezius and rhomboid area). Discoloration of the hands, one hand colder than the other hand, weakness of the hand and arm muscles, and tingling are commonly present. [citation needed]
Chest pain due to coronary ischemia commonly radiates to the arm or neck. [7] Certain individuals such as women, diabetics, and the elderly may present with more varied symptoms. [ 8 ] If blood flow through the coronary arteries is stopped completely, cardiac muscle cells may die, known as a myocardial infarction, or heart attack.
Treatment is usually via reassurance, as the pain generally resolves without any specific treatment. Occasionally it goes away after a couple of breaths. [1] The pain is agitated by expansion and contraction of the chest. Taking a deep breath and allowing the rib cage to fully expand can relieve the pain, however it will feel unpleasant initially.
Costochondritis, also known as chest wall pain syndrome or costosternal syndrome, is a benign inflammation of the upper costochondral (rib to cartilage) and sternocostal (cartilage to sternum) joints. 90% of patients are affected in multiple ribs on a single side, typically at the 2nd to 5th ribs. [1]
Symptoms of the acute coronary syndromes are similar. [8] The cardinal symptom of critically decreased blood flow to the heart is chest pain, experienced as tightness, pressure, or burning. [9] Localization is most commonly around or over the chest and may radiate or be located to the arm, shoulder, neck, back, upper abdomen, or jaw. [9]
Chest pain is pain or discomfort in the chest, typically the front of the chest. [1] It may be described as sharp, dull, pressure, heaviness or squeezing. [ 3 ] Associated symptoms may include pain in the shoulder, arm, upper abdomen , or jaw, along with nausea , sweating, or shortness of breath .