A 23 year-old woman came into the ER with severe chest pain and sob. We obtained a CTA chest to evaluate for pulmonary embolism. Instead of pulmonary embolism, the Radiologist found a pneumomediastinum on the patients left side and subcutaneous air continuing superiorly into the neck. The patient had no prior diagnosis of these conditions and had not experienced any trauma. Pneumomediastinum is not common and can be caused by several factors. These can include sudden altitude changes, trachea tear, inhalants, and trauma. Subcutaneous air or emphysema in the neck is usually a result of the pneumomediastinum. These images are examples of pneumomediastinum and subcutaneous emphysema.
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