From the Guidelines
Hampton's hump is a radiographic finding on chest X-rays that appears as a wedge-shaped, pleural-based opacity in the lung, typically indicating pulmonary infarction due to pulmonary embolism. This distinctive triangular shadow occurs when a blood clot blocks a pulmonary artery, causing death of lung tissue in that area. Hampton's hump is most commonly seen in the lower lobes of the lungs and points toward the hilum. While it's a specific sign of pulmonary embolism, it's not very sensitive, appearing in only about 25-30% of pulmonary embolism cases. The pathophysiology involves lack of blood flow to lung tissue, resulting in necrosis and consolidation that creates the characteristic wedge shape on imaging. When identified, Hampton's hump should prompt immediate evaluation for pulmonary embolism, typically with CT pulmonary angiography for confirmation, as recommended by the 2019 ESC guidelines 1, followed by appropriate anticoagulation therapy. Other signs of pulmonary embolism may include Westermark sign (regional oligemia) and enlarged pulmonary arteries on imaging. It is essential to note that the diagnosis and management of pulmonary embolism should be guided by the most recent and highest-quality evidence, such as the 2019 ESC guidelines 1, which emphasize the importance of prompt evaluation and treatment to reduce morbidity and mortality. Key points to consider in the diagnosis of pulmonary embolism include:
- Clinical presentation, such as dyspnoea, chest pain, or syncope, as discussed in the guidelines on diagnosis and management of acute pulmonary embolism 1
- Imaging tests, such as CT pulmonary angiography, which is recommended as the first-line imaging test for diagnosing pulmonary embolism 1
- The importance of prompt evaluation and treatment to reduce morbidity and mortality, as emphasized in the 2019 ESC guidelines 1.
From the Research
Definition of Hamptons Hump
- Hamptons hump is a rare radiological finding associated with pulmonary embolism 2
- It is characterized by a wedge-shaped, pleural-based opacification due to pulmonary infarction 2
Clinical Significance
- The presence of Hamptons hump is correlated with an increased likelihood of rider-type embolism, pleural effusion, and dilation of the pulmonary trunk and left pulmonary artery 2
- Patients with at least one risk factor for severe pulmonary embolism are more likely to present with Hamptons hump 2
- The presence of this sign in patients diagnosed with pulmonary embolism and pleural effusion substantially increases the risk of in-hospital death 2