Article: Sudden onset of substernal chest pare m a college student at rest: despite its name, spontaneous pneumomediastinum may be associated with a number of factors, including illicit drug use, that need to be ruled out with an appropriate history.(CASE REPORT)(Case study)

CASE

A healthy 19-year-old white male presented to the student health service complaining of substernal chest pain for 1 hour. He described the pain as "achy" and rated its severity as 5 on a scale of 0 to 10. The patient denied any radiation to the arms, shoulders, neck, or back. He stated that the pain came on suddenly while he was seated in a classroom and had been constant since it started. Onset was not precipitated by coughing, straining, or any other identifiable event. He noted that extending his neck or leaning forward exacerbated the pain. Nothing he did alleviated it. He denied palpitations, fight-headedness, nausea, sweating, or weakness. The patient ...

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