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Exercise-induced pneumomediastinum.

Tobushi T, Hosokawa K, Matsumoto K, Kadokami T - Int J Emerg Med (2015)

Bottom Line: Additionally, computed tomography showed massive pneumomediastinum surrounding the heart.Thus, he was diagnosed with spontaneous pneumomediastinum.In addition to medical history-taking, careful physical examination, which can identify the characteristic finding of a friction sound synchronous with the heartbeat (Hamman's sound), will help in the immediate diagnosis of spontaneous pneumomediastinum.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino-shi, 818-8516, Fukuoka, Japan. tobushi@cardiol.med.kyushu-u.ac.jp.

ABSTRACT

Background: A sudden onset of chest pain, which often reflects a life-threatening disease, requires prompt diagnosis in the emergency department.

Findings: A 12-year-old boy presented with sustained chest pain and dyspnea after diving into a swimming pool and was transferred to our emergency department. A chest examination noted a crunching and rasping sound at the precordium, synchronous with the heartbeat. Chest radiography showed lucent streaks and the mediastinal pleura at the left cardiac outline. Additionally, computed tomography showed massive pneumomediastinum surrounding the heart. Thus, he was diagnosed with spontaneous pneumomediastinum.

Conclusions: Spontaneous pneumomediastinum should be considered in the differential diagnosis of chest pain. In addition to medical history-taking, careful physical examination, which can identify the characteristic finding of a friction sound synchronous with the heartbeat (Hamman's sound), will help in the immediate diagnosis of spontaneous pneumomediastinum.

No MeSH data available.


Related in: MedlinePlus

A computed tomography image showing massive pneumomediastinum surrounding the heart
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Fig2: A computed tomography image showing massive pneumomediastinum surrounding the heart

Mentions: A 12-year-old boy presenting with sustained precordial discomfort and dyspnea was transferred to our emergency department. Medical history-taking revealed that he suddenly experienced this discomfort immediately after diving into a swimming pool. His vital signs, including respiratory rate, blood pressure, heart rate, oxygen saturation, and body temperature, were within normal limits. A chest examination noted a crunching and rasping sound at the precordium, synchronous with the heartbeat. Electrocardiography showed no significant abnormalities, and blood analysis only showed a slight elevation of the white blood cell count. Chest radiography showed lucent streaks and the mediastinal pleura at the left cardiac outline (Fig. 1). Additionally, computed tomography showed massive pneumomediastinum surrounding the heart (Fig. 2). Thus, he was diagnosed with spontaneous pneumomediastinum (SPM). Esophagography ruled out esophageal perforation. The pneumomediastinum spontaneously reduced after 1 week of rest, and he completely recovered without any complications.Fig. 1


Exercise-induced pneumomediastinum.

Tobushi T, Hosokawa K, Matsumoto K, Kadokami T - Int J Emerg Med (2015)

A computed tomography image showing massive pneumomediastinum surrounding the heart
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4666180&req=5

Fig2: A computed tomography image showing massive pneumomediastinum surrounding the heart
Mentions: A 12-year-old boy presenting with sustained precordial discomfort and dyspnea was transferred to our emergency department. Medical history-taking revealed that he suddenly experienced this discomfort immediately after diving into a swimming pool. His vital signs, including respiratory rate, blood pressure, heart rate, oxygen saturation, and body temperature, were within normal limits. A chest examination noted a crunching and rasping sound at the precordium, synchronous with the heartbeat. Electrocardiography showed no significant abnormalities, and blood analysis only showed a slight elevation of the white blood cell count. Chest radiography showed lucent streaks and the mediastinal pleura at the left cardiac outline (Fig. 1). Additionally, computed tomography showed massive pneumomediastinum surrounding the heart (Fig. 2). Thus, he was diagnosed with spontaneous pneumomediastinum (SPM). Esophagography ruled out esophageal perforation. The pneumomediastinum spontaneously reduced after 1 week of rest, and he completely recovered without any complications.Fig. 1

Bottom Line: Additionally, computed tomography showed massive pneumomediastinum surrounding the heart.Thus, he was diagnosed with spontaneous pneumomediastinum.In addition to medical history-taking, careful physical examination, which can identify the characteristic finding of a friction sound synchronous with the heartbeat (Hamman's sound), will help in the immediate diagnosis of spontaneous pneumomediastinum.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino-shi, 818-8516, Fukuoka, Japan. tobushi@cardiol.med.kyushu-u.ac.jp.

ABSTRACT

Background: A sudden onset of chest pain, which often reflects a life-threatening disease, requires prompt diagnosis in the emergency department.

Findings: A 12-year-old boy presented with sustained chest pain and dyspnea after diving into a swimming pool and was transferred to our emergency department. A chest examination noted a crunching and rasping sound at the precordium, synchronous with the heartbeat. Chest radiography showed lucent streaks and the mediastinal pleura at the left cardiac outline. Additionally, computed tomography showed massive pneumomediastinum surrounding the heart. Thus, he was diagnosed with spontaneous pneumomediastinum.

Conclusions: Spontaneous pneumomediastinum should be considered in the differential diagnosis of chest pain. In addition to medical history-taking, careful physical examination, which can identify the characteristic finding of a friction sound synchronous with the heartbeat (Hamman's sound), will help in the immediate diagnosis of spontaneous pneumomediastinum.

No MeSH data available.


Related in: MedlinePlus