Decreased heart sound in a healthy newborn: Spontaneous multiseptated cystic pneumomediastinum with delayed respiratory distress |
Young June Choe1, Eun eun Kim1, Ee-Kyung Kim1, Han-Suk Kim1, Jung-Eun Chun2, Woo Sun Kim2, In-One Kim2, Jung-Hwan Choi1 |
1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea 2Department of Radiology, Seoul National University College of Medicine, Seoul, Korea |
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Correspondence:
Ee-Kyung Kim, Tel: +82.2-2072-3628, Fax: +82.2-2072-0590, Email: kimek@snu.ac.kr |
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Abstract |
Spontaneous pneumomediastinum in the absence of predisposing risk factors has been rarely observed in full-term neonates. A 3-day-old neonate, delivered vaginally at term without any perinatal complications or signs of respiratory difficulty, was referred to the Seoul National University Children’s Hospital because of reduced heart sound detected during routine neonatal examination. Chest computed tomography (CT) showed air collection in the anterior mediastinum. The baby developed respiratory distress on the fourth day and required supplemental oxygen. On the seventh day, there was no sign of respiratory difficulty, and x-ray examination showed no demonstrable pneumomediastinum. Hence, careful neonatal physical examination is essential during the postnatal assessment of newborns, and spontaneous pneumomediastinum should be considered when a healthy newborn presents with reduced heart sound. |
Key Words:
Spontaneous pneumomediastinum, Term infant, Chest auscultation |
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