Emergency Med Medical News about substernal chest pain; spontaneous pneumomediastinum

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Sudden onset of substernal chest pain in a college student at rest
JAAPA, 07/14/09

Irvine DF et al. - The use of the word spontaneous in the description of spontaneous pneumomediastinum has come to include many conditions that do not meet its strict interpretation. There remain a significant number of cases, such as the one presented here, for which precipitating events cannot be or were not identified. These can be classified as idiopathic spontaneous pneumomediastinum. This may be the result of poor history-taking, lack of patient candor (specifically where illicit drugs are involved), or mechanisms yet to be identified. Despite the fact that patients with SPM typically do well, clinicians need to be aware of the life-threatening conditions that are included in the differential diagnosis and must be ruled out, a correlation with illicit drug abuse, and the risks of unnecessary procedures and treatments.

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