Acute Substernal Chest Pain and Rhinolalia in an 18-Year-Old Woman

Abstract

Case Report: An 18-year-old woman with no medical history presented to the emergency department with acute substernal chest pain and a change in her voice. Both symptoms began several hours after an episode of violent and persistent coughing which lasted several minutes. The patient reported having a mild, nonproductive cough 1 week before, but denied any trauma to the neck, chest, or abdomen. She was not in distress, her vital signs were normal, and she was afebrile. Physical examination revealed cervical subcutaneous emphysema. Lung and heart auscultation were unremarkable. The complete blood cell count and serum chemistry results were normal. Chest and neck radiographs were obtained.

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