It is a rare entity most often encountered in young adults. It is a known entity peri- and postpartum 3.
The condition is most commonly asymptomatic. Presenting symptoms can include
- non-specific chest pain
- subfebrile temperature
Interestingly, possible signs on clinical examination contain Hamman sign, a pulse-synchronous rasping sound which is believed to be caused by pneumopericardium.
Most commonly idiopathic (i.e. cryptogenic) nature. Pathomechanism is barotrauma (see main article: Macklin effect). This accounts for the association of asthma and the peripartum period causing increased intrathoracic pressures.
History and etymology
The syndrome is named after clinician Louis Virgil Hamman (1877-1946), who described it in 1939 1.
It has to be distinguished from more sinister pathology or entities, e.g. Boerhaave syndrome, as the clinical course of Hamman syndrome is usually benign and self-limiting, and as such management is often conservative 3.
- 1. L. V. Hamman Spontaneous mediastinal emphysema, Bulletin of the Johns Hopkins Hospital, Baltimore, 1939, 64: 1-21. Mediastinal emphysema, Journal of the American Medical Association, Chicago, 1945, 128: 1-6.
- 2. Weissberg D, Weissberg D. Spontaneous mediastinal emphysema. Eur J Cardiothorac Surg. 2004;26 (5): 885-8. doi:10.1016/j.ejcts.2004.05.050 - Pubmed citation
- 3. Bonin MM. Hamman's syndrome (spontaneous pneumomediastinum) in a parturient: a case report. J Obstet Gynaecol Can. 2006;28 (2): 128-31. Pubmed citation