Spontaneous Pneumopericardium in a Previously Healthy Adult: A Case Report and Literature Review
Rohini Kumari, Nidhi Kaeley*, Pavan Anjaiah, Mallapu Ajay Kumar, Parampreet Singh, Jyoti Chauhan and Sreejith Jayachandran4
ABSTRACT
Pneumopericardium-defined as the presence of free air within the pericardial sac — is an uncommon and potentially serious condition. While it is most often encountered in the setting of chest trauma, barotrauma, or thoracic intervention, truly spontaneous cases in otherwise healthy adults are rare and diagnostically challenging. We describe a 35-year-old man with no relevant medical history who arrived at the emergency department complaining of acute retrosternal chest pain and mild breathlessness. There was no history of injury, recent procedures, or identifiable precipitating events. Computed tomography (CT) of the chest confirmed air localized within the pericardial cavity, with no concurrent pneumothorax or pneumomediastinum. Transthoracic echocardiography showed preserved biventricular function and no evidence of tamponade physiology. The patient responded well to conservative treatment — supplemental high-flow oxygen, analgesics, and watchful monitoring — with complete radiological and symptomatic resolution documented on follow-up imaging at day five. This case reinforces the importance of including spontaneous pneumopericardium in the differential diagnosis of acute chest pain and highlights the pivotal role of cross-sectional imaging in confirming the diagnosis and guiding management.
