SHM Converge Scientific Abstract ePoster Gallery-Catching More Than Breath: Exercise-Related Subcutaneous Emphysema

Pdf Summary

This case report describes a rare exercise-related spontaneous air leak syndrome in a 26-year-old woman with well-controlled asthma. After completing a 21-mile open ocean swim in rough conditions, with jellyfish stings and a sensation of “breathing through a straw,” she developed facial swelling. She was initially treated for a possible allergic reaction, but on presentation to the ED she had facial edema and palpable crepitus in the neck and chest wall.<br /><br />Imaging showed extensive subcutaneous emphysema in the neck and upper chest, pneumomediastinum, and small bilateral pneumothoraces. An esophagram ruled out esophageal injury. Because her vital signs were stable and no alternative cause was found, specialists from otolaryngology, cardiothoracic surgery, and pulmonary medicine concluded that the findings were most consistent with barotrauma from strenuous exertion.<br /><br />She was managed supportively without invasive intervention and improved during hospitalization. Her inflammatory markers and white blood cell count decreased, and she was discharged with instructions to avoid air travel, Valsalva maneuvers, and strenuous activity.<br /><br />The report emphasizes that spontaneous pulmonary air leaks, including subcutaneous emphysema, pneumomediastinum, and pneumothorax, can occur after intense sports activity, especially in patients with asthma. These cases may be underrecognized because symptoms can be mistaken for simple exertional dyspnea or allergic reaction. The authors stress the importance of maintaining a high index of suspicion, pursuing prompt diagnostic work-up, and involving specialists early.

Asset Subtitle

Janice Park

Meta Tag

Author List Janice Park, Sherry Zhang

Category Clinical Vignettes

Concept Subcutaneous Emphysema

Concept Spontaneous Pneumomediastinum

Concept Air Leak Syndrome

Concept Pneumothorax

Concept Strenuous Activity

Distinguished Non-Finalist

Presenter Organization University of California, San Diego

Presenting Author Janice Park

Track Adult

Keywords

spontaneous air leak syndrome

pneumomediastinum

subcutaneous emphysema

pneumothorax

exercise-related barotrauma

asthma

open ocean swim

facial swelling

crepitus

strenuous exertion

Subcutaneous Emphysema

Spontaneous Pneumomediastinum

Air Leak Syndrome

Pneumothorax

Strenuous Activity