Delving deeper: Understanding spontaneous pneumomediastinum as an atypical cause of chest pain in young patients

Abstract

Pneumomediastinum denotes the presence of air within the mediastinum, with causative factors including trauma or conditions facilitating air intrusion into this region. It is divided into primary (spontaneous) or secondary types, contingent upon the presence or absence of a discernible etiology. Primary pneumomediastinum warrants consideration in the diagnostic framework for chest pain, particularly when accompanied by supplementary symptoms. Inquiry into potential triggers, including psychoactive substance use, is imperative, alongside ensuring comprehensive rest and outpatient monitoring for complete recuperation. Despite its infrequency, its occurrence in young adults, particularly males, is notable. Pathophysiological mechanisms entail alveolar rupture and the Macklin effect. This report presents two instances of pneumomediastinum: one in a hitherto healthy athlete and the other in a young cannabis user. Both manifested chest pain alongside additional symptoms and clinical indicators such as dysphagia and subcutaneous emphysema.