[Pneumomediastinum as a rare cause of retrosternal chest pain--report of two cases].

Pneumomediastinum (PM) is a rare cause (the rate varies from 1:8500 to 1:30000 patients) of pain in the chest. This is generally a benign entity resulting from alveolar rupture and propagation of the air into the mediastinum that affects mainly young adults. It may appear however as a complication of different procedures within the chest. Asthma, cough, vomiting, illicit drug use and all activities that require the Valsalva maneuver and/or intense breathing work or exercise were identified as predisposing factors of PM. We report cases of two patients admitted within some months to the emergency department due to chest pain. Due to acute onset of symptoms and a presence of a loud murmur along the left border of the sternum the acute pericarditis was suspected. However, after careful and detailed examination acute coronary syndrome and pericarditis were excluded. Radiologic examination and computed tomography of the chest revailed the presence of air in the mediastinum in both cases. After the diagnosis of pneumomediastinum antiinflammatory agents and antibiotics were administered. Recovery was uneventful, within two weeks form the onset a complete resolution of radiologic changes were observed.