Hamman Sign Pneumomediastinum — FRCA Final MCQ

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ModerateIntensive Care MedicineHamman Sign PneumomediastinumFRCA Final

A 50-year-old man in ICU has a large air leak through his chest drain. On auscultation, a continuous crunching sound is heard synchronous with the heartbeat. This is:

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Correct answer: E — Hamman's sign suggesting pneumomediastinum

Hamman's sign (a crunching or clicking sound heard on auscultation synchronous with the heartbeat, not respiration) indicates pneumomediastinum – air tracking into the mediastinum. It is distinct from a pleural rub (respiratory) or pericardial rub (scratchy, positional). In the context of a large air leak, air may track from the pleural space into the mediastinum.

Reference: RCOA – 2023 – Thoracic anaesthesia; BTS – 2023 – Pleural disease