Presentation
3 hour history of central chest pain.
Patient Data
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.