Hamman's Sign in a Patient with Spontaneous Pneumomediastinum

A previously healthy, 14-year-old boy presented with chest pain lasting 1 day. He had no complaints of fever, cough, dyspnea, nausea, or vomiting nor did he have any history of asthma or trauma. His height, weight, and body mass index was 165 cm, 44 kg, and 16, respectively. His vital signs were body temperature 37.0°C, heart rate 85/minutes, respiratory rate 24/minutes, and oxygen saturation 98% in room air. Upon physical examination, a crackling sound synchronous with heartbeat, the so-called Hamman's sign, was noted on cardiac auscultation in the lower left sternal border (Audio; available at www.jpeds.com).

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