Levine's sign

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Levine's sign is a clenched fist held over the chest to describe ischemic chest pain.[1] As the referred pain associated with ischemia radiates to the area of the left proximal forelimb, the right, unaffected arm is used to produce the gesture.

It is named for Dr. Sam Levine who first observed that many patients suffering from 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).


  1. ^ Edmondstone WM (1995). "Cardiac chest pain: does body language help the diagnosis?". BMJ 311 (7021): 1660–1. PMC 2539106. PMID 8541748.