Silent Dyspnea: Spontaneous Pneumomediastinum in a Heroin User

Cureus. 2021 Dec 18;13(12):e20496. doi: 10.7759/cureus.20496. eCollection 2021 Dec.

Abstract

Spontaneous pneumomediastinum (SPM) is a relatively rare presentation that often follows a benign clinical course. It is mainly triggered by underlying bronchial asthma, respiratory tract infections, strenuous activities, or illicit drug use. We present a case of an isolated primary pneumomediastinum where the patient was a 24-year-old man with underlying bronchial asthma who presented with acute onset of shortness of breath and pleuritic chest pain following snorting of an opioid-heroin. Although the clinical exam and chest radiograph were both unremarkable, the multi-detector computed tomography of the chest revealed an isolated pneumomediastinum. The patient was managed conservatively in accordance with existing evidence as SPM is known for its spontaneous recovery.

Keywords: inspiratory dyspnea; opioid epidemic; shortness of breath; spontaneous pneumomediastinum (spm); unusal causes of persistent chest pain.

Publication types

  • Case Reports