Levine's Sign
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Levine's Sign
Levine's sign is a clenched fist held over the chest to describe ischemic chest pain. 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. This clenched fist signal may be seen in patients with acute coronary syndrome (myocardial infarction 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 ...
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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 divisions of the body, each in turn composed of multiple segments. The human thorax includes the thoracic cavity and the thoracic wall. It contains organs including the heart, lungs, and thymus gland, as well as muscles and various other internal structures. The chest may be affected by many diseases, of which the most common symptom is chest pain. Etymology The word thorax comes from the Greek θώραξ ''thṓrax'' " breastplate, cuirass, corslet" via . Humans Structure In humans and other hominids, the thorax is the chest region of the body between the neck and the abdomen, along with its internal organs and other contents. It is mostly protected and supported by the rib cage, spine, and shoulder girdle. Contents The ...
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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 with blood vessels, with resultant damage to or dysfunction of tissue, i.e., hypoxia and microvascular dysfunction. It also implies local hypoxia in a part of a body resulting from constriction (such as vasoconstriction, thrombosis, or embolism). Ischemia causes not only insufficiency of oxygen but also reduced availability of nutrients and inadequate removal of metabolic wastes. Ischemia can be partial (poor perfusion) or total blockage. The inadequate delivery of oxygenated blood to the organs must be resolved either by treating the cause of the inadequate delivery or reducing the oxygen demand of the system that needs it. For example, patients with myocardial ischemia have a decreased blood flow to the heart and are prescribed w ...
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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 nausea, sweating, or shortness of breath. It can be divided into heart-related and non-heart-related pain. Pain due to insufficient blood flow to the heart is also called angina pectoris. Those with diabetes or the elderly may have less clear symptoms. Serious and relatively common causes include acute coronary syndrome such as a heart attack (31%), pulmonary embolism (2%), pneumothorax, pericarditis (4%), aortic dissection (1%) and esophageal rupture. Other common causes include gastroesophageal reflux disease (30%), muscle or skeletal pain (28%), pneumonia (2%), shingles (0.5%), pleuritis, traumatic and anxiety disorders. Determining the cause of chest pain is based on a person's medical history, a physical exam and other medical t ...
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Samuel A
Samuel is a figure who, in the narratives of the Hebrew Bible, plays a key role in the transition from the biblical judges to the United Kingdom of Israel under Saul, and again in the monarchy's transition from Saul to David. He is venerated as a prophet in Judaism, Christianity, and Islam. In addition to his role in the Bible, Samuel is mentioned in Jewish rabbinical literature, in the Christian New Testament, and in the second chapter of the Quran (although the text does not mention him by name). He is also treated in the fifth through seventh books of ''Antiquities of the Jews'', written by the Jewish scholar Josephus in the first century. He is first called "the Seer" in 1 Samuel 9:9. Biblical account Family Samuel's mother was Hannah and his father was Elkanah. Elkanah lived at Ramathaim in the district of Zuph. His genealogy is also found in a pedigree of the Kohathites (1 Chronicles 6:3–15) and in that of Heman the Ezrahite, apparently his grandson (1 Chronic ...
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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 disease, heart failure, valvular heart disease, and electrophysiology. Physicians who specialize in this field of medicine are called cardiologists, a sub-specialty of internal medicine. Pediatric cardiologists are pediatricians who specialize in cardiology. Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons, a specialty of general surgery. Specializations All cardiologists in the branch of medicine study the disorders of the heart, but the study of adult and child heart disorders each require different training pathways. Therefore, an adult cardiologist (often simply called "cardiologist") is inadequately trained to take care of children, and pediatric cardiologists are not trained to treat ...
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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, often radiating to the left shoulder or angle of the jaw, and associated with nausea and sweating. Many people with acute coronary syndromes present with symptoms other than chest pain, particularly women, older people, and people with diabetes mellitus. Acute coronary syndrome is subdivided in three scenarios depending primarily on the presence of electrocardiogram (ECG) changes and blood test results (a change in cardiac biomarkers such as troponin levels): ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), or unstable angina. STEMI is characterized by complete blockage of a coronary artery resulting in necrosis of part of the heart muscle indicated by ST elevation on ECG, NSTEMI is chara ...
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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 is retrosternal Angina, chest pain or discomfort that classically radiates to the left shoulder, arm, or jaw. The pain may occasionally feel like heartburn. This is the dangerous type of acute coronary syndrome. Other symptoms may include shortness of breath, nausea, presyncope, feeling faint, a diaphoresis, cold sweat, Fatigue, feeling tired, and decreased level of consciousness. About 30% of people have atypical symptoms. Women more often present without chest pain and instead have neck pain, arm pain or feel tired. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an Cardiac arrhythmia, irregular heartbeat, cardiogenic shock or cardiac arrest. Most MIs occur d ...
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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 partial obstruction or spasm of the arteries that supply blood to the heart muscle. The main mechanism of coronary artery obstruction is atherosclerosis as part of coronary artery disease. Other causes of angina include abnormal heart rhythms, heart failure and, less commonly, anemia. The term derives , and can therefore be translated as "a strangling feeling in the chest". An urgent medical assessment is suggested to rule out serious medical conditions. There is a relationship between severity of angina and degree of oxygen deprivation in the heart muscle. However, the severity of angina does not always match the degree of oxygen deprivation to the heart or the risk of a heart attack (myocardial infarction). Some people may experience s ...
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Pedro Alurralde Cossio
Pedro is a masculine given name. Pedro is the Spanish, Portuguese, and Galician name for ''Peter''. Its French equivalent is Pierre while its English and Germanic form is Peter. The counterpart patronymic surname of the name Pedro, meaning "son of Peter" (compared with the English surname Peterson) is Pérez in Spanish, Peres in Galician and Portuguese, Pires also in Portuguese, and Peiris in coastal area of Sri Lanka (where it originated from the Portuguese version), with all ultimately meaning "son of Pero". The name Pedro is derived via the Latin word "petra", from the Greek word "η πέτρα" meaning "stone, rock". The name Peter itself is a translation of the Aramaic ''Kephas'' or '' Cephas'' meaning "stone". An alternative archaic variant is Pero. Notable people with the name Pedro include: Monarchs, mononymously *Pedro I of Portugal *Pedro II of Portugal *Pedro III of Portugal *Pedro IV of Portugal, also Pedro I of Brazil *Pedro V of Portugal *Pedro II of Braz ...
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