[Paradoxical costal shift throughout inspiration (Hoover's sign) in patients admitted because of dyspnea]

Abstract

Objective: To study the frequency and diagnostic usefulness of Hoover's sign (paradoxical costal shift throughout inspiration) in patients admitted because of dyspnea.

Patients and methods: 268 patients admitted because of dyspnea in an Internal Medicine Department were included in the study. Physical examination was carried out on the first day of admission to establish the presence of Hoover's sign.

Results: Hoover's sign was present in 62 patients of 82 with a diagnosis of chronic obstructive pulmonary disease (COPD) (sensitivity: 76%), in 3 patients of 101 (3%) with a diagnosis of congestive heart failure, in 3 patients of 23 (13%) with a diagnosis asthma, and in 6 patients of 62 (10%) with other diagnoses. Specificity of Hoover's sign for EPOC diagnosis was 94%.

Conclusions: Hoover's sign is a frequent finding in patients admitted because of EPOC and is found only rarely in patients without obstructive pulmonary disease. This sign contributes useful information for the evaluation of patients admitted because of dyspnea.