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Pneumomediastinum: a cause of chest pain
  1. K Naganuma,
  2. M Ito,
  3. Y Aizawa
  1. keibow{at}

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A previously healthy 18 year old male visited our hospital for chest pain of sudden onset. Although the heart sounds were normal, crunching and clicking sounds were heard over the left sternal border. An ECG showed normal sinus rhythm with a heart rate of 63 beats/min, and neither ST changes nor arrhythmias were present. The patient's chest x ray showed an abnormal liner shadow along the left side of the heart border, suggesting pneumomediastinum (below left), which was confirmed by chest computed tomography (below right). With bed rest, his clinical course was uneventful. Pneumomediastinum is rare but can be a cause of chest pain

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