BMJ Case Reports 2018; doi:10.1136/bcr-2017-222756
  • Rare disease

Case of chest pain in a young man

  1. Priya Narwal2
  1. 1Pulmonary and Critical Care Medicine, Hartford HealthCare, Hartford, Connecticut, USA
  2. 2Rhode Island Hospital, Providence, Rhode Island, USA
  1. Correspondence to Dr Ankit Gupta, ankitguptapulmonary{at}
  • Accepted 1 January 2018
  • Published 12 January 2018


A young man with a history of smoking presented with acute-onset chest pain after lifting weights. He also noticed a change in his voice, tightness in his neck and difficulty breathing. A chest radiograph showed soft tissue emphysema in the neck. A CT scan of the chest revealed moderate amount of pneumomediastinum tracking into the neck and down to the diaphragm. He was haemodynamically stable and had no hypoxia or dysphagia. He was monitored for 48 hours and discharged home after resolution of his symptoms. A chest radiograph repeated after 6 weeks was normal.


  • Contributors AG, AVP and PN were all involved in writing the manuscript, literature review and proof-reading.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article