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Hamman’s Sign

Other known aliases – Hamman’s crunch

Definition – systolic precordial crunching sound that occurs with each contraction of the heart that is best heard over precordium in the left lateral decubitus position

Clinical Significance – this is one of the classic physical examination findings in pneumomediastinum or pneumopericardium as a result of trauma to the bronchial tree, bleb rupture, or esophageal rupture.

History – Named after Louis Virgil Hamman (1877-1946), an American internists who received his medical doctorate from Johns Hopkins University in 1902. He was considered one of the great physicians of his era and made significant progress in the management of tuberculosis as the head of the Phipps Tuberculosis Clinic at Johns Hopkins. He described this finding in patients with spontaneous mediastinal emphysema in two separate articles, first in 1939 in The Bulletin of Hopkins Hospital, and then in JAMA in 1945.

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References

• Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
• Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
• Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
• Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
• Up To Date. www.uptodate.com
• Cohen AG. Hamman’s Crunch: An historical note. Bulletin of the New York Academy of Medicine. 1971; 47(9):1111-2. [pubmed]
• Hamman, L. Spontaneous mediastinal emphysema. Bull. Hopkins Hosp. 1939;64:1-21.
• Hamman L. Mediastinal emphysema: The Frank Billings Lecture. JAMA. 1945;128(1):1–6.