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Hoover's sign is often a sign that a lung disease, such as COPD, is becoming severe. Diagnosed through clinical examination, rapid medical treatment must be implemented. Hoover's sign concerns another branch of medicine, neurology.
Definition of Hoover's sign in pulmonology: diaphragm, respiration?
In Pneumologythe they signed Hoover is characterized by a paradoxical inward movement of the lower part of the rib cage during inspiration.
“Normally, during inhalation, air enters the lungs. This respiratory phenomenon is possible thanks to the ribs which widen horizontally in order to widen the thoracic cavities. explains Doctor Sophie Bauer, thoracic and cardiovascular surgeon. “This mechanism allows the lungs to fill with air. When exhaling, the ribs come together so that the air is better evacuated. In the case of they signed Hoover, the ribs, instead of being placed horizontally, will come closer together. This causes the rib cage to shrink instead of the expected increase.”.
In a healthy subject, the transverse diameter of the lower part of the thorax increases. In the cas du signe de Hoover, instead of moving apart and increasing in volume, the chest walls move closer together, in connection with the reduction in transverse diameter and the horizontalization of the diaphragm. THE they signed Hoover or paradoxical breathing is the consequence.
Symptoms: how to recognize chest distension?
The doctor can recognize the Hoover sign thanks to clinical examination. “This clinical sign is easily observed: we place our hands on the patient's chest. If the hands move closer together instead of apart, then there is Hoover sign.”
Concerning the symptoms, the patient presents breathing difficulties. “Hoover's sign is a sign of the severity of the pathology in question. specifies the thoracic surgeon. In general, people suffering from this sign have feeling of lack of air. However, this is not an impression, since the lung is not filling properly.
What are the possible causes (pulmonary pathologies, COPD, obstruction, etc.)?
The they signed Hoover is most often a marker of severity in diseases with laryngeal or bronchial obstruction, in which air no longer passes. This is particularly the case for bronchitis or chronic obstructive pulmonary disease (COPD) or severe asthma.
Chronic obstructive bronchitis (COPD)
The COPD can be complicated by emphysema, which is the progressive destruction of the pulmonary alveoli. These alveoli are located at the end of the bronchioles and participate in the absorption of oxygen molecules. “Air bubbles are then created in part of the lungs, causing a reduction in the capacity for oxygen exchange in the lungs. Medical treatment is necessary to improve the body's oxygenation. continues Dr. Sophie Bauer.
Large air bubbles preventing the remaining healthy part of the lung from filling can be removed. “We may be required to obstruct these bubbles endobronchially with interventional endoscopy. The other technique consists of removing them by videothoracoscopy (equivalent to laparoscopy but at the thoracic level). The bubbles are stapled, cut and then removed.”
Severe asthma
The they signed Hoover sometimes appears in severe asthma. “Asthma should be treated as early as possible to prevent its progression. Basic treatment and treatment of the crisis are prescribed. Research into the causes of asthma is also important.”
Obstruction by a foreign body
Obstruction of the upper airway can cause Hoover's sign to appear and the person can no longer breathe. “If the obstruction is at the level of the larynx, you must perform the Heimlich maneuver: you place yourself behind the person and apply very strong pressure against the stomach, towards the center and upper body in order to remove what is obstructing the larynx. In the event of obstruction by edema, the edema will need to be treated..
In summary, the they signed Hoover alerts to the severity of lung or respiratory system dysfunction, such as asthma, COPD with advanced emphysema (lung destruction) or tracheal obstruction. When a patient has a chronic lung disease, such as COPD, they can become oxygen dependent. To prevent possible respiratory complications, the causes of COPD must be treated as early as possible; most of the time this involves stopping tobacco poisoning.
Hoover's sign in neurology
There is another they signed Hooverin a different field, that of neurology. “Hoover's sign in neurology is rare. This is a sign sought for neuro-functional pathologies. Patients describe partial paralysis, in which we find no true neurological cause. Often, neurologists use this term to differentiate between organic paralysis, that is, a disease of destruction of motor brain areas by obstruction or hemorrhage of vessels such as l’AVC or following physical trauma, and false paralysis, which still remains a cerebral dysfunction”.
The patient with neurological Hoover's sign often requires treatment with psychotherapy. His psyche leads to brain dysfunctions, causing a feeling of paralysis of a limb, particularly a lower limb. When the attending physician cannot find the origin of the paralysis, he refers the patient to a doctor specializing in neurology. THE they signed Hoover is then sought by a neurologist during a specialized neurological consultation. “Functional brain MRI shows dysfunction without organic lesion. Thanks to psychotherapy, the information transmission circuits in the brain can return to normal.concludes the doctor.