Spontaneous Pneumomediastinum in Marijuana Users

Abstract

This article presents two individuals with different clinical presentations who experienced spontaneous pneumomediastinum following the chronic use of marijuana. Pneumomediastinum has been associated with marijuana use due to the prolonged inhalation and breath-holding mechanisms employed during consumption. The first case involves a 24-year-old woman with a history of anxiety and chronic marijuana use, who presented to the emergency department with atypical chest pain and shortness of breath. The second case involves a 21-year-old man with no previous medical history, who experienced acute chest pain after smoking marijuana. Both individuals exhibited signs of pneumomediastinum on imaging studies and were treated with oxygen therapy and analgesics. The cases emphasize the importance of considering pneumomediastinum in patients with atypical chest pain, particularly in chronic cannabis users.

Keywords: atypical chest pain; causes of pneumomediastinum; macklin phenomenon; marijuana and pneumothorax; marijuana use.

Figure 1. Pneumomediastinum extending from the neck to the pericardium at the base of the lungs.

Figure 2. Chest X-ray reveals signs of pneumomediastinum with the presence of air surrounding the heart and in the subcutaneous tissues of the neck.

Figure 3. Computed tomography (CT) of the thorax pneumomediastinum with air present in the anterior and middle mediastinum.

Figure 4. Computed tomography (CT) of the thorax pneumomediastinum extending to the cervical soft tissues.