Postpartum Chest Pain Secondary to Spontaneous Pneumomediastinum

A 21-year-old pregnant woman (Gravida 1, Para 0; 39 week 6 days) had an uncomplicated vaginal delivery. Two hours after delivery, she complained of sudden-onset substernal pleuritic chest pain that was 10/10 in severity. Pain did not change with position and was not associated with dyspnea or diaphoresis. Physical examination and vital signs were normal. Electrocardiogram showed normal sinus rhythm. Troponin was 0.15 ng/mL (normal: 0 – 0.09). C-reactive protein and erythrocyte sedimentation rate were elevated at 14.4 mg/L (normal: 0 – 10.0) and 31 mm/hr (normal: 0 – 20) respectively.