The Heart Point Sign

A case report describes the echo findings of a patient with a traumatic left sided pneumothorax. Although the subcostal view was unremarkable, upon imaging the parasternal region, the sonographer noted a flickering phenomenon where the heart was clearly visualized in late diastole, but would disappear in mid- systole only to reappear in late diastole during the next cardiac cycle. This ‘‘heart point’’ sign occurs because as the heart fills with blood in diastole, it enlarges and displaces the air from the precardiac space, allowing the heart to transiently contact the chest wall and be visualized with US. As the heart contracts during systole, the pneumothorax fills the space between the heart and the anterior chest wall, preventing the transmission of US and causing the heart to momentarily disappear from view.

The Heart Point Sign: Description of a New Ultrasound Finding Suggesting Pneumothorax
Academic Emergency Medicine 2010;17(11):e149–e150