title: Spontaneous pneumomediastinum presenting as rhinolalia and chest pain.
abstract: This report discusses a case of spontaneous pneumomediastinum in a 25-year-old medical student. The patient presented with chest pain and a tonal change in voice. Symptoms occurred after an episode of stretching and were exacerbated by coughing. There was no history of underlying respiratory  disease and he was a non-smoker. Management was conservative. At the four-week follow-up appointment, bronchoscopy and computed tomography of the thorax demonstrated complete resolution. Spontaneous pneumomediastinum is uncommon, with rhinolalia being a rare presenting feature. It should be  considered as a differential diagnosis in patients with chest pain associated with a change in voice. A detailed history may reveal preceding activities associated with raised intrathoracic pressure.
authors.affiliation: Imperial College Healthcare NHS Trust, 46 High Street, Gosforth, Newcastle upon Tyne NE3 1LX, UK. williambreakey@gmail.com
authors.forename: R W F
authors.initials: RW
authors.lastname: Breakey
authors.forename: G
authors.initials: G
authors.lastname: Walker
authors.forename: W
authors.initials: W
authors.lastname: Oldfield
mesh_terms: D000208:Acute Disease; D000328:Adult; D002637:Chest Pain / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000150:complications* / Q000000981:diagnostic imaging; D035583:Rare Diseases / Q000150:complications / Q000000981:diagnostic imaging; D013064:Speech Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed