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Chest radiograph showing mediastinal air with extensive subcutaneous gas present.
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It was later incidentally detected that he had subcutaneous emphysema and chest x-ray demonstrating pneumo-mediastinum (Fig. 1).
CT images showing diffuse pneumomediastinum with associated soft tissue gas in the lower neck and upper chest bilaterally.
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CT with and without water-soluble oral contrast were done and demonstrated pneumomediastinum with no signs of esophageal or tracheobronchial defects (Fig. 2).
(A) Initial ECG showing sinus bradycardia, signs of LVH, and Wellens' sign in V2-V3. (B) Repeat ECG shows a persistence of Wellens' sign.
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ECG done during workup showed ST/T wave changes suggesting Wellens' sign (Fig. 3a). This finding did not change or progress on repeat ECG (Fig. 3b).