Spontaneous Pneumomediastinum: A Rare Case of Bradycardia

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Pneumomediastinum is an uncommon phenomenon that may occur in a number of clinical contexts, such as chest trauma, barotrauma, esophageal rupture, or asthma, but it may also occur idiopathically; the latter condition is often referred to as “spontaneous pneumomediastinum” (SPM), formerly as Hamman syndrome. Typically, symptoms associated with SPM are benign, and the condition is self-limited, despite an impressive physical examination largely owing to the presence of subcutaneous emphysema. We illustrate 2 patients who presented with SPM associated with asymptomatic bradycardia, most likely due to the increased stimulation of receptors in the aortic arch and/or carotid sinus, producing increased vagal tone.

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