A 30-year-old man presented with a sudden onset of retrosternal chest pain and neck tenderness after an intranasal cocaine usage. He reported “mild and continuous” pain with no radiation or other associated symptoms. He had no significant medical history. Besides the 5-year history of cigarette smoking, no other cardiovascular risk factor was noted.
His vital signs were all within the normal range. Physical examination Respiratory auscultation was normal without additional sounds. Cardiac sounds were unremarkable without murmurs or clear “Hamman’s sign.” A moderate amount of subcutaneous emphysema was noted on the right side of the neck. Laboratory investigations Blood analysis: Normal Arterial blood gas on room air: Respiratory alkalosis without metabolic compensation ECG: Normal sinus rhythm without ST-elevation with normal repolarisation Chest X-ray and CT scan were performed (Cover…
