Radiographic Levine's sign

Case contributed by Dr Roger Smyth


3 hour history of central chest pain.

Patient Data

Age: 55 years
Gender: Female


The left hand is overlying the left hilum and left lower lobe. Allowing for that no abnormality is seen. 

Case Discussion

Levine's sign is the finding of a clenched fist held in front of the chest, indicating ischemic chest pain. In this case, the patient presented to the emergency department with chest pain and tightness. A portable frontal chest radiograph was taken demonstrating a round increased density overlying the left heart border with a ring-shaped density more centrally. At first glance, these could be mistaken for cardiomegaly and a mitral valve replacement but the radius and ulna are clearly visible when examining the left lower zone of the radiograph. In this case, a diagnosis of unstable angina was made.

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Case information

rID: 71447
Published: 8th Oct 2019
Last edited: 10th Oct 2019
System: Cardiac, Chest
Inclusion in quiz mode: Included

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